Is there anything better in the pipeline?

[JamieD]

I was wondering if there are any really promising drugs in the pipeline that are novel ways of treating HIV?

Needless to say the current anti-HIV drugs leave something to be desired. They may extend life, and supress the virus, but they also do a number on our livers, cholesterol levels, kidneys, and physical appearance.

Is there anything better then this on the way? I have seen a bunch of papers in scientific journals talking about Nuclear Factor Kappa inhibitors, therapeutic vaccines, aspirin like molecules, etc but nothing ever seems to come of these things. Nuclear Factor Kappa Inhibitors would be great because they aren't very toxic, and they have little to no risk of resistance. Why has one not been developed? Why are there none even in clinical trials?

[redhotmuslbear]

Jamie,
All of the "boutique" chemicals coursing through the human body work in a delicate balance;  and any new chemicals introduced into the body, even "promising HIV therapies" will have some unintended consequences, great or small, as a result.  The problem with the meds we have is the same as what's holding back the various potential therapies you note:  what spells death and doom for a microscopic virus may upset the host's metabolism quickly or ever so gradually as to create an end result where the user wishes s/he had just left HIV alone.  Take NF-kB inhibitors, for example.... dysregulation of NF-kB has been linked to cancer, inflammatory and autoimmune diseases, septic shock, viral infection and improper immune development.

The other issue with new therapies is cost.  Leaving rants about CEO salaries and marketing budgets aside, drug companies are going to be slow to bring to market new therapies that financially outstrip the willingness of insurance companies and governments to pay.

In the words of Chuck Brown, father of Go-go, "Keep whatcha got until ya get whatcha need..."

Cheers,
David

[Jake72]

Is there anything better then this on the way? I have seen a bunch of papers in scientific journals talking about Nuclear Factor Kappa inhibitors, therapeutic vaccines, aspirin like molecules, etc but nothing ever seems to come of these things. Nuclear Factor Kappa Inhibitors would be great because they aren't very toxic, and they have little to no risk of resistance. Why has one not been developed? Why are there none even in clinical trials?

I think a lot of us have our eyes open for 'the next big thing'.  Do a search through this forum, and you'll see that some therapeutic vaccines are indeed being studied (the Geovax vaccine, for instance, would be both preventive and therapeutic).   There's also gene therapy, which seems interesting. 

While I certainly agree that any chemical (even supposedly innocuous over-the-counter stuff) can have unforeseen effects upon our bodies, I do think that something much better than what we currently have-in terms of side effects and basic convenience-is going to come along.   

[powerpuff]

hi jake any new news?

[Jake72]

Check out the thread on Geovax    

[milker]

Needless to say the current anti-HIV drugs leave something to be desired.

They make you live a "good life", whereas only 10 years ago this disease was still a death sentence or a seriously ill life.

Milker.

[JamieD]

Yes, well, my understanding is that life threatening side effects, also known as "Grade 4 Events" in the JAMA, are not all that uncommon and occur in about 10%+ of people taking the drugs for long periods of time. I was asking if there was anything bettER then what is currently available.
How many other drugs do you think would be approved with safety and side effect profiles of anti-HIV medications? Would Prozac have been approved if 10%+ of people taking it experienced life threatening liver problems? No, it would not have even been approved if 1% of people taking it developed life threatening liver problems.

P.S. The study/analysis I am referring to is one titled "Grade 4 Events in the era of HAART" and is from the JAMA. I do realise that a portion of liver related deaths amongst HIV+ persons is due to HBV, or HCV infections but that doesn't account for the very substantial portion of people who take HAART who develop life threatening liver damage.

[JamieD]

I am sure you have all seen this before, but I'll post it anyway.

http://216.239.51.104/search?q=cache:-3iOtKe-baAJ:www.helpforhiv.com/grade4.pdf+Grade+4+Events+HAART&hl=en&ct=clnk&cd=3&gl=us


I dunno, I guess having the option of dying of a Grade 4 event versus dying of AIDS is better have no option at all, right?    I have to keep telling myself that everyday that I put these pills into my mouth, even though I have no side effects at the moment I have no idea of what is going on behind the scenes. I must keep reminding myself that Grade 4 events are better then AIDS. I chant it like a mantra.

[milker]

I agree, but even the side effects are "better" now. AZT when given in the 80s was a side effects nightmare, I remember people taking it and vomiting their guts for hours, losing weight faster than you could imagine, and basically having to go to the hospital every couple of weeks to recover. So there is progress done, not as fast as we'd like, for sure

Milker.

[Jake72]

And also, those of us on HAART are usually monitored for other functions (kidney, liver, etc.) when we go in for bloodwork.  At the first sign of anything 'going south', the doctor will often switch a patient's medications or, at the very least, watch him/her very closely, prepared to switch if the trend continues. I agree, though, that better therapies are definitely needed.