Table of Contents: AIDS Community Research Initiative of America

2004

ACRIA - Winter 2004/05 - Vol. 14, No.1

Working With Healthcare Providers: This issue of ACRIA Update focuses on the relationships between individuals and their healthcare providers. We thank the writers who have shared their personal experiences – the good, the bad, and ugly – as well as the healthcare providers who have been willing to offer their perspectives. We hope that some of the tips included in these pieces will help you to develop a more productive relationship with your provider or, if necessary, help you move on and find a provider with whom you connect.
Personal Perspective: Walking Away: Carlos H. Arboleda; I have the best doctor on earth – caring, compassionate, knowledgeable, funny, and, possibly, a liberal. But this hasn’t always been the case. Having spent several years as a health educator, talking to both patients and healthcare providers, I thought of myself as confident and savvy enough to choose and have a relationship with a good, new doctor when the time came. Was I wrong. I had moved to a new city in 2000 and, being new in town and having a rather small pool of doctors in my health plan to choose from, I just went down the list and randomly selected a doctor for an annual physical and to check a minor pain I had.
Personal Perspective: Positively Isolated: Name Withheld; Prior to ending up living in the sparsely populated area of Michigan's Upper Peninsula, I had resided in Portland, Oregon. That metropolis is also where I tested positive in 1987. It was in Portland that I encountered a few phobias of healthcare workers on the occasions that I did seek consultation at the county medical clinic. One incident in particular stands out in my mind. One doctor had an aversion to making any kind of physical contact. He didn't mind chatting up a storm, though.
Personal Perspective: Partnership In Care: L. Jeannine Bookhardt-Murray, MD; Over the past 20 years of caring for people with HIV/AIDS, there have been challenges and rewards. The rewards outweigh the challenges. I like to focus on the rewarding parts of my practice. The greatest reward for me is getting to know each of my patients and to see them stay healthy. If you're struggling with your health, with adherence to medication, to understand what your provider is talking about, or to keep up with your medical appointments, then please read on.
Personal Perspective: Do As You're Told?: Patricia Storey; I remember growing up as a child in the 60's and 70's when life was oh so much easier and less complicated - at least in my mind.
Personal Perspective: The Road to Empowerment: Kath Webster; Although I no longer subscribe to the traditional roles of the doctor leading and the patient following, I have often asked myself, "what would I do without my HIV doctor?" Shortly after my diagnosis, I became very sick and considered my doctor to be a lifeline. I depended on him to be knowledgeable and up-to-date, to recommend the best course of treatment, to listen to my concerns, to reassure me and give me hope…a tall order!
Personal Perspective: Both Sides of the Pill Bottle: Richard S. Ferri, PhD, ANP, ACRN, AAHIVS, FAAN; Sometimes the numbers just don't add up. You're sitting there in an exam room and everyone is telling you how wonderful you're doing. Your numbers are just great! Your T-cells are way up and your viral load is way down. What could be better? The answer is - you. In this high tech medical world of measuring and monitoring every branch of DNA, viral particles, and countless other laboratory parameters, sometimes something very strange happens. The patient (and that would be you and me) gets lost in the lab limbo tango. What makes matters worse is that people with HIV sometimes jump right into this dance with glee.
Personal Perspective: Avoiding the Power Struggle: David Elfstrom; At times, a meeting with your doctor can feel like a battle. Perhaps you've read about a new treatment that sounds exciting. Who knows your body better than yourself? You've read the drug information book, you know what symptoms to expect. You're being an educated patient. And yet here's the doctor shooting holes in your arguments and resisting your suggestions of new treatments to look into. What's gone wrong?
Personal Perspective: Person First/Patient Second: Paul Stabile, PA-C; As the Director of Clinical Care of the William F. Ryan Community Health Center, I provide medical care to people living with HIV as part of a multi-disciplinary treatment team. The Ryan Center is a not-for-profit community health center that provides primary and preventive care, including integrated HIV clinical and support services to underserved, minority communities in northern Manhattan. As part of my duties at the Center, I spend a lot of my time administering quality assurance projects, but I also have the pleasure of providing an orientation to medical services for each new HIV-infected patient. I have found the approaches discussed below to be helpful in establishing good working relationships with my patients.
Personal Perspective: What If God Was One of Us?: Mark Milano; My journey to find the right doctor has been long, difficult, and frustrating. Before AIDS, I had viewed doctors quite simply: they were godlike beings who gave you pills that made you better. So in 1982 when I was told I might have AIDS, I was surprised that my "infallible" doctors didn't know what to do or even exactly what it was. In hindsight, this was a blessing in disguise - it forced me to re-evaluate my relationship with doctors. Suddenly I was on my own. When told there was no treatment, I said, "Thank you, I'll take care of it myself." I went to the health food store, began reading what little was available, and ate up every news story that mentioned AIDS.
Personal Perspective: Learning to Trust: Penni Cleverley; It's hard to talk about my relationship with my physician without first talking about my experience before I became sick with the dreaded PCP (Pneumocystis pneumonia). Prior to getting PCP, I was not a compliant patient, nor was I very open and honest with my physician. I only took my medications if I was around someone who would notice that I wasn't taking them. My doctor's office is an hour and a quarter each way by car, and every time I went, I knew that I would be forced to wait at least an hour. I'd cancel my appointment if I could think of any good excuse to do so. Hang nail or headache anyone?
What Do All Those Letters Mean, Anyway?
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ACRIA - Fall 2004 - Vol. 13, No.4

HIV Treatment & Care: From Approval to Access: Since the beginning of the AIDS epidemic, the response in the United States to this devastating crisis has been primarily emotional and often cruel - denial, disgust, neglect, fear, and blame. Only rarely has our country addressed the epidemic as the true healthcare crisis that it is. Like the rest of our healthcare system, benefits and medical services for most people with HIV come from a variety of fractured and piecemeal sources, often with cumbersome eligibility requirements.
The Food and Drug Administration: The Process of Approval: Tim Horn; For every dollar the typical American spends, approximately 25 cents goes to products that are regulated by the U.S. Food and Drug Administration (FDA). We're talking about everything from food, to drugs, to radiation-emitting products like cell phones, to cosmetics. With respect to drugs used for medical conditions, the regulatory role of the FDA reflects the sometimes paradoxical needs of consumers: facilitating rapid access to new therapeutics that show promise for patients, while also protecting them from products that are ineffective, unsafe, and marketed using unproven claims.
Medicaid and Medicare: Ripping Holes in the Safety Net: Anne Donnelly; Some forty years since these words were spoken, the United States remains the only Western industrialized country that hasn't found a way to provide healthcare to all its citizens. Although government programs like Medicaid and Medicare have done an admirable job of serving vulnerable people, they remain part of a fractured system with many gaps.
USEFUL RESOURCES
Personal Perspective: Waiting for ADAP: Henry E. Dendy; I have been HIV-positive for 20 years and, because of a sporadic work history since my diagnosis, I've used the North Carolina AIDS Drug Assistance Program (ADAP) on occasion. I had to use ADAP again two years ago when I went on long-term disability. The nausea and diarrhea were constant, and the dosing schedule wouldn't allow me to work. When I went on long-term disability, my insurance ended. I applied for Medicaid and, for the first time, encountered an ADAP waiting list. I was on that waiting list for three months.
The Ryan White CARE Act: AIDS is Still an Emergency: Robert Cordero; Over a decade and a half ago, America and the world were introduced to a courageous young boy with AIDS named Ryan White. He was from Kokomo, Indiana and had been infected with HIV as a result of the blood product transfusions required to treat his hemophilia. The public discrimination that he faced transformed his life and the lives of others living with HIV and AIDS forever. Ryan made it possible for many Americans to understand the struggle to battle HIV and its accompanying stigma. He was truly a champion for that time in our history.
AIDS Drug Assistance Programs: A Promising Start, A Shaky Future: Lei Chou; Finding out you are HIV-positive is a life altering experience, as anyone who has been through it can tell you. That future you thought was waiting down the road suddenly disappears. Priorities take a big tumble, fear and confusion reign. Living in the only industrialized country without universal healthcare, HIV-positive Americans must face an additional issue that few thought critical in the prime of their lives: access to healthcare.
AIDS DRUG ASSISTANCE PROGRAM CONTACT NUMBERS
Patient Assistance Programs: Getting Free Drug from the Drug Makers: Brian D. Klein, MA, LMSW; The ever-escalating costs of many prescription medications have created barriers to accessing necessary treatment for people who are uninsured, underinsured, and/or have a low income. The somewhat negative term often used to refer to folks in this category is "medically indigent." More Americans are falling into this category each year, with 15.6 percent of the U.S. population (45 million people) uninsured as of 2003 according to the U.S. Census Bureau. It can be argued that the pricing practices of the pharmaceutical industry have helped to create this situation. But industry has also created a response to the problem by creating Patient Assistance Programs (PAPs).
Drug Company Patient Assistance Program Contact Numbers: Most drug companies have programs to provide free drug to people with no insurance, inadequate insurance, or financial difficulties. Each program has different requirements, and your healthcare provider often needs to make the phone call. The drug company will sometimes take your information over the phone, but will usually send you or your healthcare provider a form to fill out. If you don't qualify for public insurance such as ADAP or Medicaid and you meet the eligibility requirements of the program, you can get free drug.
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Generous Contributions & Masthead

ACRIA - Summer 2004 - Vol. 13, No.3

Over 50 with HIV: J Daniel Stricker, Editor in Chief; This issue of ACRIA Update discusses a topic of rapidly growing importance to the HIV community and public health system nationwide - the aging of the United States HIV population. ACRIA became interested in pursuing research around the health and supportive needs of people living with HIV/AIDS (PLWAs) who are 50 or older three years ago when this group was identified as an emerging special needs population by our Research Policy Advisory Committee for New York State.
HIV and Aging: Andrew Shippy; The HIV/AIDS epidemic in the United States is changing. Government agencies, community-based organizations, and even the media are finally aware that HIV doesn't discriminate. Most of us know that women and people of color are at risk for HIV infection, but older adults are rarely mentioned. Since the beginning of the epidemic, there have been hundreds of books, thousands of newspaper and journal articles, and hundreds of thousands of Internet pages about HIV and AIDS. But a 1998 review in the Journal of Gerontological Nursing found only 54 publications, including two books (AIDS in an Aging Society [1989] and HIV/AIDS and the Older Adult [1996]), that discussed older adults living with HIV.
Responses to Treatment in Older Adults: Andrew Shippy; Many of the illnesses common among older people are related to the aging process. As people age, their bodies aren't able to repair and rebuild damaged cells (organs, tissues) as rapidly as those of younger people. So, what does this mean for older adults with a disease like HIV that attacks and destroys the body's defenses (CD4 and CD8 cells)? HIV-positive older adults are more likely to have additional medical problems like diabetes and high blood pressure, and more physical limitations than younger adults with HIV.
It's Always Something . . .Medical Complications of Aging with HIV: Jerome Ernst, MD; Aging affects us all - something that was unfortunately not true for most of the HIV-positive population until recently. But thanks to the wonders of modern science, many HIV-positive Americans are joining the march to older age together with millions of their fellow citizens. In the year 2000, 34 million people in the United States were older than 65 years; by 2025, this number will almost double.
Personal Perspective: Why Am I Still Here?: Paul Muller; Living with AIDS over 50... I had to sit and think on that a while to bring it into focus. I am a "Long-Term Survivor," having been HIV-positive almost half my life. Is HIV/AIDS still a major concern for me now that I'm over 50? One thing I like about writing a "personal perspective" is that you're thinking about only your own situation. So let me begin.
Personal Perspective: Love, Sex, Friends, Medications, Spirituality, Health: Marilyn McBride; I'm a 50 year old mother who has been HIV-positive for ten years. I'm currently in great health and spirits due to loving friends and a spiritual family that has supported me since day one. At first, I thought that my life was over and I wouldn't be around to see my grandchildren grow up. I really wasn't expecting to live to see 50, so I thank God for my health and recovery from substance abuse.
Personal Perspective: Smell the Coffee!: Joan Warner; Family, friends, jobs, and drugs were a huge part of my life - and then came my HIV diagnosis in 1990 at the age of 51. I had developed a serious case of diarrhea that had gone on for two and a half months. I visited four different hospitals, but no one could tell me what was wrong. They gave me Kaopectate and Imodium A-D, but nothing worked. In order to endure the train ride to work, I had to pin hand towels around my butt like Pampers. At one point, I decided that, if I didn't eat, the diarrhea would stop. That didn't work - it just kept coming and I lost 40 pounds. I looked and felt like I was going to die. My family was even making preparations for my final day.
Personal Perspective: Awakening a Giant: J. Edward Shaw; HIV remains an important part of my life for many reasons, but I'm always wondering how the disease impacts my natural aging process. True, HIV is still one of the top priorities in my life, along with essentials like financial independence. But as I grow older, other issues have equal importance - did I do the best that I could have; did I leave something unfinished; will my legacy allow others to enjoy my labor?
Personal Perspective: I'm Too Old For This: Name Withheld, MD, FACS; I first encountered the word "homosexual" at age 14 in a 1954 Time magazine article and shuddered with the dread suspicion that it described me. The surprise of knowing that I was not "the only one" was completely annihilated by the disgust and derision I realized was implicit in the word. I resolved to do whatever necessary not to be "one of them." This was possible for me because I also found females entrancing and proceeded to date, marry, and father two sons. I did retain an active interest in (and craving for) male anatomy, which was partially satisfied by my work as a general surgeon, which required the regular examination of men's bodies.
Personal Perspective: Moving Forward: Yolanda Birthwright; I must say first and foremost that I'm blessed through all life's experiences.
Personal Perspective: There's Always Room for Hope: Sharon; It's been ten years now, and it's hard to think of my life without AIDS. I was diagnosed in 1994, two weeks after my husband was diagnosed. He had two T-cells at the time and I had seventy. I was a married woman, raising dogs, cats, birds, children, and a husband. I could not believe that this had happened to me. I'm now 59 years old, widowed, and a grandmother to four.
Selected Resources for Older People with HIV: Organizations, Videos, Books, and Research Journals
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ACRIA - Spring 2004 - Vol. 13, No.2

A Guide To Treatment Information Resources: In our HIV treatment education work at ACRIA, one of our responsibilities is to become familiar with a multitude of topics and the many resources available that address them. We spend as much time gathering information and verifying its accuracy as we do explaining what we've learned to other people. Over time, we've gathered hundreds of information resources, the most useful of which we'd like to share with you.
HIV Treatment Information Resources: Organizations, Newsletters, Websites, and Hotlines: *Some materials available in Spanish; The following list includes treatment organizations, websites, and hotlines that we trust and have found useful in our work at ACRIA. Our brief descriptions try to give you an idea of the information available on each site but aren't intended to be complete. Each entry includes the name of the organization or website (often both); the treatment newsletter published (in italics), if any; the website address where applicable; and addresses and phone numbers for organizations that are willing to mail materials if you call or write them.
From Primary Sources to Anecdotes: Making Sense of Treatment Information: Rebecca Young, Ph.D.; Staying "informed" about treatment options - whether for your own health decisions or to help clients and friends with theirs - can be overwhelming. I don't know whether it's more frustrating to find that there's no information on a treatment you're interested in or to find that there's so much information that you don't know where to start - let alone how to sort out the good stuff from the fluff.
Personal Perspective The Good Stuff: Lisa Frederick; In this article, I suggest some strategies for locating reliable information that I have found useful both in teaching and in making my own treatment decisions. I also try to untangle some of the terminology about information sources that always seem to pop up but aren't usually defined - terms like "primary sources" and "anecdotal evidence."
10 Things To Know About Evaluating Medical Resources on the Web: The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading. This short guide contains important questions you should consider as you look for health information online. Answering these questions when you visit a new site will help you evaluate the information you find.
Personal Perspective: Ode to the World Wide Web: Tim Horn; I confess. I am an unabashed World Wide Web junkie. I shudder at the thought of how much time I have spent over the years gawking at websites dedicated to sex, automotive design and repair, sex, online auctions and shopping (I will never set foot into a store to go Christmas shopping again), sex, and what always claims to be the best bouillabaisse recipe known to man. And those are just for fun.
Personal Perspective: The Journey: Octavio Vallejo, MD, MPH; As a person living with AIDS for more than a decade and a health care professional, I learned early on that knowledge is power. Indeed, treatment information is the cornerstone to surviving AIDS with a high quality of life and minimal complications from both the disease and the medications we have to take.
Personal Perspective: I Read Somewhere...: Heidi M. Nass; When I was first diagnosed, I remember coming across a survey of long-term HIV/AIDS survivors in the reams of materials I read. It said that, in addition to having good attitudes and support and things like that, long-term survivors tended to be people who 'took charge of their health.' They took an active interest in their condition and learned about the various treatments. Survivors regarded themselves as captains of their health care teams, or some metaphor like that, and saw their physicians as members of the team.
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ACRIA - Fall 2003 / Winter 2004 - Vol. 12, No.4 / Vol. 13, No. 1

This issue of ACRIA Update was a collaborative effort, researched and written by:

James Learned, ACRIA's Director of Treatment Education and Editor of ACRIA Update; Mark Milano, treatment educator at ACRIA and longtime AIDS treatment activist; and Donna M. Kaminski, ACRIA's Associate Director of Treatment Education.
Special thanks to Tim Horn for his editorial review of some of the contents of this issue.

Drugs! Drugs! Drugs!: An Overview of the Approved Anti-HIV Medications: This double issue of ACRIA Update includes discussions of each of the currently approved anti-HIV medications (antiretrovirals). Depending on whether you count new formulations of existing drugs, there are now between nineteen and twenty-one antiretrovirals available in the U.S., including four that were approved in 2003 alone.
Nucleoside and Nucleotide Reverse Transcriptase Inhibitors: The NRTIs are also called nucleoside/nucleotide analogs or "nukes" for short. Once HIV has entered a cell, usually a CD4 cell, it uses an enzyme called reverse transcriptase to change its genetic material, RNA, into DNA. The viral DNA is then integrated into the human DNA in the nucleus of the cell. This programs the cell to make new copies of HIV. Once the cell is activated, the DNA in the nucleus creates pieces of HIV.
Retrovir: Retrovir (AZT, azidothymidine, ZDV, zidovudine) has been studied more than any other antiretroviral used for the treatment of HIV. It was the first anti-HIV drug approved by the FDA (March 1987) and has been used in clinical trials of almost every new antiretroviral since that time.
Videx: Videx, Videx EC (ddI, didanosine, dideoxyinosine) - Videx was the second anti-HIV drug approved by the FDA. Its approval in October 1991 was unique in that it was the first time that a drug was approved based on surrogate markers such as lab results (in this case, increased CD4 cells) rather than on clinical endpoints such as disease progression or survival.
Hivid: Hivid (ddC, zalcitabine, dideoxycytidine) is rarely used anymore, but, as with most new drugs, its approval by the FDA in June 1992 was eagerly anticipated. Now, its three-times-a-day dosing, poor showing in clinical trials, multiple drug interactions, and potentially serious side effects combine to make it the least prescribed nucleoside analog.
Zerit: Zerit, Zerit XR (d4T, stavudine) - Zerit became the fourth drug available for the treatment of HIV when it was approved by the FDA in June 1994. The drug's initial approval was only for people with advanced HIV disease who no longer responded to or who couldn't tolerate the three drugs available at the time - Retrovir (AZT), Hivid (ddC) and Videx (ddI).
Epivir: Epivir (3TC, lamivudine) is a powerful drug with minimal side effects, an easy dosing schedule, and few drug interactions. It may be one of the most useful nucleoside analogs available, particularly if it's used strategically. By the time it received accelerated approval from the FDA in November 1995, close to 30,000 people had already received Epivir through the largest expanded access program ever.
Ziagen: Ziagen (abacavir sulfate, ABC), approved by the FDA in December 1998, was the first new NRTI to become available in the era of Highly Active AntiRetroviral Therapy (HAART). As such, it had to compete for a special place in combination therapy. Initial studies of Ziagen had shown it to be as powerful as a protease inhibitor at lowering viral load when taken alone, so the drug's manufacturer, GlaxoSmithKline, positioned (and priced) it as an alternative to a protease inhibitor or non-nucleoside as part of a three-drug combination.
Viread: Viread (tenofovir disoproxil fumarate, TDF) was approved by the FDA in October 2001 and is still the only nucleotide analog available. Nucleotide analogs work like nucleoside analogs (Retrovir [AZT], Videx [ddI], Zerit [d4T], etc.)
Emtriva: Emtriva (emtricitabine, FTC), the most recently approved nucleoside analog, probably caused less excitement when it was approved in July 2003 than any antiretroviral so far. Many people viewed it simply as a "me-too" drug because its chemical structure and activity are so similar to Epivir (3TC).
Combivir: Combivir is a formulation of two drugs - Retrovir (AZT) and Epivir (3TC) - into one tablet. The two have long been used together, originally as a two-drug combination, and then as the backbone of many three-drug regimens. Retrovir has been available separately since 1987 and Epivir since 1995.
Trizivir: Trizivir is not a single drug, but a formulation of three drugs into one tablet. All three drugs - Retrovir (AZT), Epivir (3TC), and Ziagen (abacavir) - continue to be available separately.
NNRTIs: Non-Nucleoside Reverse Transcriptase Inhibitors: The NNRTIs are also called non-nucleosides or "non-nukes" for short. These drugs interfere with HIV's reproduction process at the same point as the NRTIs but in a different way. The NNRTIs attach themselves to the reverse transcriptase enzyme, changing its shape and preventing it from functioning properly. Reverse transcriptase can't translate HIV RNA into DNA. If there's no viral DNA to integrate into the nucleus of the cell, HIV reproduction is slowed down.
Viramune: Viramune (nevirapine, NVP) was the first non-nucleoside reverse transcriptase inhibitor (NNRTI) approved by the FDA, but has taken a back seat to Sustiva (efavirenz) due to the latter NNRTI's impressive results in clinical trials. New data could change that, as we find that Viramune's "poor cousin" status may more likely be the result of unfortunate research decisions rather than a lack of strength.
Rescriptor: Rescriptor (delavirdine, DLV) received FDA approval in April 1997, becoming the second non-nucleoside reverse transcriptase inhibitor (NNRTI) available. Mixed results from clinical trials and a difficult dosing schedule (two pills three times a day) combine to make it one of the least-prescribed antiretrovirals.
Sustiva: Sustiva (efavirenz, EFV) - Its FDA approval in September 1998 made Sustiva the third available NNRTI. Since then, it has become one of the most popular antiretrovirals and is often recommended for a person's first regimen because of its effectiveness and once-a-day dosing. While its nervous system side effects can be a problem, many people have found them to be temporary or at least manageable.
PIs: Protease Inhibitors: The protease inhibitors, or PIs, work at a later stage in the HIV life cycle than the NRTIs and NNRTIs. Once HIV's genetic material has been changed from RNA to DNA and is integrated into the DNA in the cell's nucleus, the cell produces a long chain of genetic material (proteins and enzymes). HIV's protease enzyme acts like a pair of scissors, cutting the chain into smaller pieces which then come together to form new copies of the virus.
Invirase and Fortovase: Invirase and Fortovase (saquinavir mesylate, SQV) are different versions of the same drug. Invirase caused a big splash in December 1995 when it became the first protease inhibitor approved by the FDA - the first in a whole new class of antiretrovirals. Unfortunately, Invirase isn't absorbed by the body as well as other anti-HIV drugs, so a more readily-absorbed formulation called Fortovase was eventually released in November 1997.
Norvir: Norvir (ritonavir, RTV) is one of the strongest but least prescribed protease inhibitors on the market today. In several studies, Norvir has shown a strong reduction in viral load and an increase in CD4 cells, especially when taken with one or two other anti-HIV medications.
Crixivan: Crixivan (indinavir sulfate, IDV was approved by the FDA in March 1996, just two weeks after Norvir (ritonavir). Crixivan's ability to lower viral load to undetectable levels in most people who used it in a three-drug combination made it the "gold standard" of the day. As more drugs with less severe food restrictions and fewer doses per day have become available, Crixivan's popularity has waned.
Viracept: Viracept (nelfinavir mesylate, NFV) has enjoyed wide use since its FDA approval in March 1997. By 1999, it was the most frequently prescribed protease inhibitor (PI) on the U.S. market and today is second only to Kaletra (lopinavir/ritonavir).
Agenerase and Lexiva: Agenerase (amprenavir) and Lexiva (fosamprenavir calcium) are different versions of the same drug. Agenerase was the fifth protease inhibitor to hit the market when the FDA approved it in April 1999. Agenerase's lackluster performance in clinical trials and its high pill count have made it one of the least-prescribed protease inhibitors.
Kaletra: Kaletra (lopinavir/ritonavir, LPV) is one of the strongest and most prescribed protease inhibitors on the U.S. market today. Its approval by the FDA in September 2000 marked the first time that a protease inhibitor (PI) was designed and approved as a boosted drug - the capsules contain the active drug, lopinavir, along with a small amount of Norvir (ritonavir).
Reyataz: Reyataz (atazanavir sulfate, ATV) was approved by the FDA in June 2003 as the first protease inhibitor (PI) to be taken once a day. For people who are just starting treatment, studies showed that Reyataz lowers viral load almost as well as Sustiva (efavirenz), a strong non-nucleoside, and almost as well as (although not better than) Viracept (nelfinavir), a relatively weak PI.
Entry Inhibitors: Entry inhibitors work at HIV's first point of contact with a human cell. This occurs at an earlier stage in the HIV lifecycle than the other antiretrovirals. To successfully infect a cell, HIV needs to attach to and enter the cell through a series of steps.
Fuzeon: Fuzeon (enfuvirtide, T-20) ushered in a new class of anti-HIV drugs (fusion inhibitors) when it received FDA approval in March 2003. For people whose HIV had become resistant to many drugs from the other classes, it offered new hope of bringing viral loads down below detection, but it came with two major obstacles.
Glossary of Terms
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This information is designed to support, not replace, the relationship that exists between you and your doctor.
©2004. ÆGIS.