Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 23 July 1996
Maggie Fox

Glaxo Wellcome Plc said a combination of 3TC (Epivir) along with the standard HIV drug AZT, and sometimes with other drugs, caused a 54 percent drop in progression to AIDS or death.

An independent group of scientists set up by Glaxo, which licenses Epivir from the Canadian company BioChem Pharma Inc, recommended the move 16 months after the study started in March 1995. It was due to end in March 1997 but has now been stopped.

Glaxo said halting the trial would allow all the nearly 2,000 participants to benefit. Under the experiment, some were given the drug and others were not.

Glaxo shares rose on the news. They were up 18 pence at 909p after trading at around 895p just before the announcement.

"Expectations for Epivir have been gradually rising as the idea of using it as one of the mainstays of these cocktails has become conventional wisdom," said SG Strauss Turnbull pharmaceuticals analyst Paul Diggle.

"Some of the results of these sort of combinations are looking little short of spectacular and today's news is reinforcing in people's minds that the AIDS market is changing and that Glaxo is in an extremely strong position to be the biggest beneficiary of it," he said.

The study, known as Caesar, included 1,892 HIV patients from Canada, Australia, Europe and South Africa.

Cocktail therapy is the new hero of the fight against AIDS. Scientists reported at an international conference on AIDS in Vancouver earlier this month that combinations of three or more drugs could wipe out all evidence of the HIV virus.

Although they cannot tell how long the effects will last -- and AIDS can take more than a decade to develop -- they hope the combination therapies offer the first clues to a cure.

Nick Partridge of British AIDS charity the Terrence Higgins Trust welcomed the findings with some reservations. "Overall, this confirms the benefits of combination therapy," he said.

"However, what we don't know from this initial analysis is the impact of resistance and the development of resistance. One of the strong themes that came out of Vancouver is that just adding one drug to a combination is not necessarily the best way to maximise the impact of three-drug therapy."

He added: "This trial raises as many questions as it answers. It does not provide any clear, definitive answers as to what combinations people with HIV should take."

The cocktail successes have been the first good news in the 15-year battle against the AIDS pandemic which has killed nearly six million people.

The stars are the protease inhibitors, drugs that attack the HIV virus late in its cycle of replication.

Epivir is in a class of drugs known as nucleoside reverse transcriptase inhibitors, which includes AZT, Roche's zalcitabine (ddC or Hivid) and Bristol-Myers Squibb's ddl (Videx). They attack the virus earlier on in the cycle.

The hope is that, by hitting the virus in several places at once, it will be unable to recover.

Glaxo's Caesar trial did not use any protease inhibitors. A spokesman said the 54 percent result was an average of patients given AZT plus 3TC, as well as those given AZT, 3TC and either ddC or DDI.

Epivir has been licensed in the United States, Brazil, Canada, New Zealand, Uruguay, Australia, South Africa and Switzerland.

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