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New drugs may make AIDS therapy easier

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Two new drugs may soon offer HIV-infected people the first easy-to-take alternative to protease inhibitors, the landmark medicines that made AIDS a treatable disease.

The results of large-scale testing of these medicines were released Monday at the 12th World AIDS Conference. They showed that both appear to be about as effective as protease inhibitors, which have been the key ingredient of the so-called AIDS cocktail until now.However, the new drugs require taking far fewer pills than the standard mix, and they may help those who fail to respond to protease inhibitors and suffer bad side effects.

The two drugs are DuPont Pharmaceuticals' Sustiva and Glaxo Wellcome's Ziagen. Sustiva is known generically as efavirenz and Ziagen as abacavir. Both companies have asked the U.S. Food and Drug Administration for approval to sell the drugs, based on the data presented at this week's meeting.

The drugs will be given in combination with two older AIDS medicines, like protease inhibitors. Taken early in infection, the protease inhibitor combinations keep people from getting sick. When given to people whose bodies are already ravaged by the virus, they often produce dramatic turn-arounds.

Their biggest drawback for many is the requirement of taking as many as 20 pills on a precise schedule throughout the day. Some doctors are reluctant to prescribe them to people who are not motivated to take them on schedule, because missing even a few pills allows the evolution of mutant viruses that are completely impervious to the drugs.

When taking protease inhibitors, "you have to plan, you have to be organized, and you have to be disciplined. There is a need for simpler treatments, ones that patients can adhere to better," said Dr. Schlomo Staszewski of Goethe University in Frankfurt, Germany. He was involved in testing both new drugs.