New drug could help patients resistant to existing ARVs

A new HIV drug has shown promising results when used in conjunction with existing combination therapy and could increase the options for those developing resistance to treatment.

In a study recently published in The Lancet medical journal, darunavir — approved by the FDA in June 2006 — was combined with another drug, ritonavir, and added twice daily to patients’ combination therapy. Both darunavir and ritonavir belong to a class of drugs called protease inhibitors that block the protease enzyme, which the HI virus needs in order to make copies of itself.

After a year of use, nearly half of patients taking darunavir reduced the concentration of HIV in their blood to below recordable levels while only 10 percent of the patients on regular combination therapy achieved similar results.

In addition, 61 percent of those prescribed the new drug showed a 10-fold decrease in the amount of HIV genetic material in their blood in comparison to 15 percent of patients on typical treatment.

Studies in Thailand, conducted over just 6 months, showed similar results.

The recent study, conducted by an international team of doctors in Barcelona, also found darunavir increased patient CD4 counts by more than 5 times the increases displayed by those on regular therapy.

Eric Goemaere, head of programme for Medecins Sans Frontieres (MSF) in South Africa, says darunavir may open up treatment possibilities for HIV-positive people who have developed drug resistance to first-and second-line treatments but cautioned it was too early to tell for sure.

Of those who began MSF's initial ARV programme in Khayelitsha, South Africa 5 years ago, about 20 percent are now on second line treatment, according to Goemaere. Of those, 1 percent have developed resistance with no remaining options for treatment.

Aspen Pharmacare, South Africa's largest generic company, hopes to begin importing and distributing darunavir to African countries as countries begin approving it, said the company's senior executive Stavros Nicolaou. Nicolaou expects the drug to start being approved by regulatory bodies on the continent, within the next six months.

ll/kn