HIV AIDS News [International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

Tolerability and Compliance
The importance of keeping the level of virus as low as possible, for as
long as possible, to prevent viral replication, has highlighted the importance of
tolerability. Therapy must be as well-tolerated as possible in order to be taken
for an extended period of time without significant side-effects that might lead to
patient non-compliance, or even require discontinuation of therapy. CRIXIVAN,
which was taken in triple therapy by approximately 600 patients in Protocol 035
and ACTG 320 combined, was generally well-tolerated. Of patients taking triple
combination therapy with CRIXIVAN, only three percent (1/33) in Protocol 035
and three percent (19/577) in ACTG 320 discontinued the blinded portion of the
study due to an adverse event.
"To continue to suppress the virus, patients must stay on therapy," said
Jeff Chodakewitz, M.D., executive director of Clinical Research at Merck
Research Laboratories and a co-author of both studies. "The tolerability of
CRIXIVAN may help keep patients on therapy, which should help keep virus
levels suppressed."
Patients in current clinical trials are encouraged to regularly drink water to
maintain hydration (1.5 litres/day) to prevent nephrolithiasis, or kidney stones.
The vast majority of patients who have experienced nephrolithiasis have
continued on therapy.
Resisting Resistance
A limiting factor in the use of antiretroviral drugs has been the fact that
HIV can grow at an amazing rate, even in the presence of some antiretroviral
drugs, enabling the virus to accumulate the genetic mutations that ultimately
lead to drug resistance.