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  • Title: Now there are eleven, but so what?
    Author: Gilden D.
    Journal: GMHC Treat Issues; 1997; 11(4/5):1-3. PubMed ID: 11364371.
    Abstract:
    Eleven drugs are now available in the United States for suppressing HIV. Delavirdine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), blocks an enzyme that allows infection of new cells with HIV. It is hoped that drugs of this class can be combined with fresh nucleoside analogs, reserving HIV protease inhibitors for resistant infections. Clinical trials showed no result differences between combining delavirdine with various other drugs to the same combinations without delavirdine. Delavirdine does have disadvantages, including the large number of pills that have to be taken and its interference with the pharmacokinetics of other drugs. However, in a group of patients treated in private practice, a rising viral load was reduced when delavirdine was added to the regimen, perhaps by raising the blood level of indinavir to a high enough level to give positive results. The physician studying these combinations, Dr. Paul Bellman, treats his patients intuitively, and has not actually monitored the indinavir levels in any of his patients. One area that has lacked much study is the combination of protease inhibitors and NNRTI; this type of combination warrants further study since the various drugs simultaneously target different enzymes required for the HIV life cycle. More drugs are being developed in this area that will hopefully not be as prone to causing mutations in HIV, and thus resistance.
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