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Being Alive
MEDICAL UPDATE: Next Generation of Antivirals
Mark Katz, M.D. and reported by Jim Stoecker
March 5, 1993
Being Alive 1993 Mar 5: 6

While the controversy continues on whether AZT, ddI or ddC is the superior antiviral, the preliminary studies of what we have termed the next generation of antivirals go forward. These new antivirals intervene at a point in the HIV life cycle different from the reverse transcriptase phase where AZT/ddI/ddC intervene. The hope is that the next generation of antivirals will be more specifically directed to halting HIV replication and thus have a greater long-term effect than currently available antivirals.

To date, we can only say that we are still awaiting data on the effectiveness of the tat and protease inhibitors that are now being tested. ACTG 213 is a three site study of tat inhibitors. Ninety-six men and women, with T-cells in the 50-500 range, are included in this ongoing study. UCLA is preparing a study of tat inhibitors specifically as treatment for KS.

The studies of protease inhibitors also continue. Some half dozen companies have protease inhibitors in development, and Phase II studies of some of these drugs are underway in Europe. In this country, ACTG 229 is a four site study of 300 people whose T-cell counts are below 300 and who have been taking AZT for at least four months. The protease inhibitor will be combined with AZT and/or ddC and compared to AZT/ddC in combination. A second ACTG study of protease inhibitors is being planned for those in higher CD4 ranges.