Abstract

AIDS: Combination antiretroviral treatments, especially triple combinations, are often talked about, but rarely used. Laboratory studies are showing that some combination results are better, or worse, than might have been predicted, in suppressing HIV in laboratory cultures. Some studies have also suggested that it is better to combine drugs than to alternate them. Dr. Margaret Poscher suggests that it is better to begin the different drugs at or close to the same time, if possible, to reduce resistance. Laboratory tests suggest that the combinations may be most active when the viral concentration is low, suggesting that they may work better in early stage HIV infection, rather than in late stage infection. However, laboratory work can only provide guidance or suggestions as to what combinations may work in the human body. Recently, Glaxo Wellcome applied to the Food and Drug Administration (FDA) for accelerated approval for 3TC. 3TC would be used in combination with AZT as first-line treatment for adults with CD4 counts under 500, and for children who meet the Centers for Disease Control and Prevention (CDC) guidelines for treatment with antiretrovirals. This may change the standard for treating persons with HIV infection with counts of under 500.