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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Anti-HIV Drugs Continue To Fight HIV Infection after 3 Years
4 July 2000 | Volume 133 Issue 1 | Page 35
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "3-Year Suppression of HIV Viremia with Indinavir, Zidovudine, and Lamivudine." It is in the 4 July 2000 issue of Annals of Internal Medicine (volume 133, pages 35-39). The authors are R.M. Gulick, J.W. Mellors, D. Havlir, J.J. Eron, A. Meibohm, J.H. Condra, F.T. Valentine, D. McMahon, C. Gonzalez, L. Jonas, E.A. Emini, J.A. Chodakewitz, R. Isaacs, and D.D. Richman.
What is the problem and what is known about it so far?
Anti-HIV medication regimens that include the powerful drugs called protease inhibitors decrease the amount of HIV in the blood of patients with HIV infection. Decreases in the amount of the virus in the blood are associated with better clinical outcomes for patients. However, it is still not known how long these multiple-drug medication regimens remain effective.
Why did the researchers do this particular study?
The researchers wanted to find out whether a three-drug medication regimen to treat HIV infection continues to keep the amount of virus in the blood at low levels and promotes increases in Tcells (immune cells) after 3 years of continuous treatment.
Who was studied?
The study included 33 HIV-infected patients who had previously been in a shorter study of a treatment regimen that consisted of the anti-HIV drugs indinavir, zidovudine, and lamivudine. These 33 patients agreed to continue taking the drugs.
How was the study done?
The researchers followed the study patients for 3 years after they began the drug regimen. They collected information about blood tests and the side effects of the drugs. One of the blood tests measured the viral load (the amount of virus in the blood). When anti-HIV medicines are working, the viral load remains low.
What did the researchers find?
After 3 years of therapy with the drugs, 20 of 31 patients had very low viral load, indicating that the drugs were still fighting the HIV infection effectively. Twelve of the 33 patients who entered the study experienced kidney stones, probably as a side effect of one of the anti-HIV drugs (indinavir). Most of these patients could continue taking the drugs.
What were the limitations of the study?
This study was very small, and its results may not apply to patients receiving other multiple-drug regimens. Missing doses could explain why the drug did not continue working in some patients.
What are the implications of the study?
After 3 years, the anti-HIV medication regimen of lamivudine, zidovudine, and indinavir continues to keep the amount of virus in the blood low and promotes increases in Tcells (immune cells) in a large proportion of patients.
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