New potential long-lasting NRTI

[Cosmicdancer]

This compound is in the early phase of development.  Hopefully it will pan out. 

New Compound Could Be Alternative Strategy for Preventing HIV Infection

ScienceDaily (Jan. 25, 2010) — With the help of effective drug therapies, HIV patients are living longer, healthier lives. Now, researchers want to improve these drug therapies and develop alternative preventative strategies, such as vaginal gels and creams that contain the same or related compounds used in treatments for people infected with HIV. A University of Missouri researcher is developing a compound that is more potent and longer-lasting than current HIV therapies.

"This new compound, EFdA, is 60,000 times more potent than any other drug that is currently being used to treat HIV," said Stefan Sarafianos, assistant professor of microbiology and immunology in the MU School of Medicine and investigator in the Christopher Bond Life Sciences Center. "This compound has a different chemical makeup than other approved therapies and creates an exceptional amount of antiviral activity. EFdA is activated very quickly and stays long in the body to fight the virus and protect from infection."

When a person is exposed to HIV, the virus invades healthy cells that play an important role in keeping the body's immune system strong. In order to multiply itself and remain in the body, the HIV virus relies on certain proteins. One protein, known as reverse transcriptase, is the main HIV enzyme responsible for viral replication. Effective HIV drugs control the virus by blocking the functions of these viral proteins.

EFdA is a nucleoside reverse transcriptase inhibitor (NRTIs). NRTIs target reverse transcriptase and can stop the virus from duplicating and spreading. Currently, there are eight clinically approved NRTIs, but they can protect cells for only short periods of time. With EFdA, patients could be protected for two days instead of few hours and would not need to take the drug as often, Sarafianos said.

"Infection is the result of an overwhelming attack of the virus, but if you manage to keep the viral load low, the body has a mechanism to defend itself and clean up the virus on its own," Sarafianos said. "The goal of our research is to drop the virus to very low or "undetectable" levels. Patients with suppressed viral loads will have increased life expectancy. Not all drugs work with all patients, and new resistant viral strains develop. Therefore, it's important to keep adding to our possible options for therapy."

Sarafianos hopes EFdA also can double as a preventative agent in the form of a vaginal gel or cream. This would provide additional protection to women whose partners refuse to use condoms.

Sarafianos collaborates with Michael Parniak, at the University of Pittsburgh and Hiroaki Mitsuya at the National Institutes of Health. Sarafianos' recent research was published in The Journal of Biological Chemistry.

http://www.sciencedaily.com/releases/2010/01/100125173448.htm

[veritas]

Cosmicdancer,

Although still in pre-clinicals, EFdA seems promising. Here is some pre-clinical data:

http://antiviralresistance.org/abstract7_2009.pdf


v

[Miss Philicia]

I actually ponder whether or not an every other day drug regimen would lead to worse adherence for many patients.

[veritas]

You might be right Miss P. One would not only have to remember what time of day to take your meds, but also the appropriate day. Of course , if one is organized, such a system could be set up rather easily.

On a personal note, I'd do it in a minute.

Of course, the decision will not have to be made for awhile.

[tommy246]

I actually ponder whether or not an every other day drug regimen would lead to worse adherence for many patients.

I  suppose it depends on the type of individual but i for one will never forget to take a pill that keeps me alive whether it be once a day or once a month , and secondly this type of discovery i believe will eventually lead to once a week ,once a month, once a year etc

[Miss Philicia]

Uh, your personal feelings have no bearing on the issue.  It's a matter of the demographics of HIV/AIDS, and what the preponderance of patients would do.  

Duh.

[Assurbanipal]

I actually ponder whether or not an every other day drug regimen would lead to worse adherence for many patients.

tend to agree, here.  With my osteoporosis pill it was very easy to remember the once a week meds -- "if it is Monday I must take a pill".  But it is harder to remember the once a month pill  -- "if it is the 10th, I must take a pill.

Of course that's partly because they have to be taken first thing -- absolutely before anything INCLUDING COFFEE -- and while I can usually remember what day of the week it is WITHOUT COFFEE, which date in the month??? 

(did I mention the NO COFFEE part?    )

[Hellraiser]

I  suppose it depends on the type of individual but i for one will never forget to take a pill that keeps me alive whether it be once a day or once a month , and secondly this type of discovery i believe will eventually lead to once a week ,once a month, once a year etc

Never say Never.

[Miss Philicia]

(did I mention the NO COFFEE part?    )

Oh dear, that would mess me up too

[tommy246]

Uh, your personal feelings have no bearing on the issue.  It's a matter of the demographics of HIV/AIDS, and what the preponderance of patients would do.  

Duh.

This website is about personal opinions and you love giving out yours  i merely stated that for me it wouldnt be an issue , this site is for everybody to give there opinion not just about you and your arrogant attitude and constant urge to pick a cat fight with anybody im astounded the mods put up with your constant bitching , grow up and get a life , either help people on here or move on if you have nothing worth saying.

[Miss Philicia]

This website is about personal opinions and you love giving out yours  i merely stated that for me it wouldnt be an issue , this site is for everybody to give there opinion not just about you and your arrogant attitude and constant urge to pick a cat fight with anybody im astounded the mods put up with your constant bitching , grow up and get a life , either help people on here or move on if you have nothing worth saying.

In your effort to take offense and, once again, boil everything down to your own experience you missed my larger point.  When drug research moves into a certain level I'd assume that they'd not be so interested in what 1, 2 or 10 people can do with the proposed dosing, but what 100 or more can do satisfactory in terms of adherence.  I hope this makes more sense to you. 

This has nothing to do with the nature of internet message boards and the posting of opinions.  It's about which opinion is more informed.  If you find my reasoning above faulty then by all means say so, but explain why.  Thank you, and have a nice weekend.

[Nestor]

Under normal circumstances, I too think that every other day would be harder for me to keep track of than every day.  But in another thread we were talking about people who want to travel extensively or live abroad for a year.  If this is a stepping-stone to something that would be once a week, it would have huge implications for freedom of movement.  Imagine someone who was going to spend a year travelling around the world.  52 pills would be a lot easier to carry than 365. 

[Okealyshire]

I suspect for most people that rituals can be easy to adopt. For example, I wear 30-day extended wear disposable contact lenses. Every Sunday night I remove the lenses and soak overnight in an enzyme cleaner. On the first of each month I remove the pair I'm wearing and insert a new one. These procedures are easy to remember.

Many of us can also take advantage of tools to help remind us of regular activity. As an example, you could create a recurring event in a Google calendar to take your weekly or monthly NNRTI on a certain date, and have the calendar send you a reminder email or deliver a text message to your phone.

[tommy246]

Uh, your personal feelings have no bearing on the issue.  It's a matter of the demographics of HIV/AIDS, and what the preponderance of patients would do.  

Duh.

I am english and we dont start sentences with UH and end them in DUH thats just you trying to be offensive and trying to belittle me and my comments, Your personal opinion is that you think adherence would be more difficult taking a pill every two days instead of everyday , my personal opinion is that it wouldnt be ,its not rocket science . We all have different methods when it comes to taking our meds i personally use a pill box by the side of my bed i would quite simply remove the pills from the days i dont need to take them,now do you understand you gave your opinion and i gave mine . Thats my final say on the matter .

[Miss Philicia]

Thanks Tommy.  I know how insightful the experience is of someone on Atripla for two months versus someone who has dealt with non-one-drug-a-day regimens now for 17 years.  In fact, I've been on all of these, many of which (at the time) had food/no food restrictions.

Zidovudine (AZT) (1993)
Epivir (3TC) (1995)
Emtriva (2003)
Viread (2001)
Videx (ddI) (1993)
Zerit (d4T) (1994)
Ziagen (1998)
Hivid (ddC) (1992)

Sustiva (1998)
Viramune (1996)

Invirase (saquinavir)(1995)
Kaletra (2000)
Norvir (1996)
Prezista (2006)
Viracept (1997)

Fuzeon (2003)

Isentress (2007)

Hydrozyurea

The simple fact is that once you go from something (somewhat) simple such as twice daily though with food restrictions, though still much more complex than Atripla, to something like three times a day -- two doses with food, one without, it all becomes wildly more difficult (speaking from experience, of course).

I've also done enough volunteering with HIV/AIDS, and live in an urban environment with a hugh HIV infection rate, to know that a huge, huge sector of the HIV patient pool consists of people where you want to make adherence easier, not more difficult.  Having them on one NRTI that they take once a week, with other drugs they take daily, will lead to higher incidences of resistance in the larger HIV population.  If they can make an entire drug regimen that is once a week then I would find this useful, but not until then.

To use your phrase, Tommy, "its not rocket science".

[Ann]

Tommy, Miss P, everyone is entitled to their opinion, even if that opinion is wrong or misguided. All we ask is that when someone presents their personal opinion, they make it clear that's what it is - their personal opinion.

Can we please stop bickering now? Thanks!

Ann