TreatmentUpdate 69, Volume 8, No 5; July 1996
Sean Hosein

To reduce production of HIV and help the immune system resist HIV infection, researchers are testing combinations of anti-HIV drugs. Loviride is a drug that affects an essential viral enzyme called RT (reverse transcriptase) but that drug is not 'related' to AZT or similar drugs. Drugs such as loviride reduce production of HIV and are not as toxic as AZT. The problem with loviride and related drugs such as nevirapine is that HIV quickly becomes resistant to their effects. This is why combination therapy is essential when using these drugs.

Study details

Researchers in Germany enrolled 20 HIV-infected subjects (2 female, 18 male) for their study. Their CD4+ cell counts ranged between 12 and 464 cells. Before entering this study, 15 subjects had used anti-HIV agents including AZT and ddI. At the time they entered the trial none of the subjects had any life-threatening infections. Ten subjects received a combination of 2 drugs; 600 mg/day of AZT and 300 mg/day of loviride. The other ten received both AZT and loviride in the same dose as used above but they also received 3TC 300 mg/day. Subjects received the drugs for 6 months. After this time subjects could receive the triple combination for 12 months if they wished.

Results - CD4+ cells

At least half the subjects receiving the 3 drug combination had their CD4+ cell counts increase by 78% by the 12th week of the study compared to their pre-study values. By the 6th month of the study this figure had decreased to 45%. At least half of the subjects receiving the double combination had an increase in their CD4+ cell count of roughly 25% by the 4th week of the study. By the 6th month of the study, however, the CD4+ cell counts fell to their pre-study levels.

Results - HIV

Subjects receiving triple combination had dramatic decreases in the amount of HIV in their blood. After the 8th week the amount of HIV detected rose slowly but remained below the pre-study level. In contrast, subjects receiving the double combination had production of HIV return to their pre-study level by the 24th week.

Toxicity

Five subjects on double combination and 6 on triple combination had side effects which included:

* tiredness

* fever

* headache

* diarrhea

The researchers concluded that the combinations were "well tolerated." Other studies with loviride are underway in several countries. Loviride is made by Janssen Research.

REFERENCES:

1. Staszewski S, Miller V, Rehmet S, et al. Virological and immunological analysis of a triple combination pilot study with loviride, lamivudine and zidovudine in HIV-1 infected patients. AIDS 1996;10:F1-F7.

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