To: grayhairs who wrote (6991 ) 3/21/2001 11:21:20 PM From: john.d Respond to of 14101 Mark, here you go, another article on the failure of existing AIDS treatment. The completion of the WF10 phaseII trials are very timely given that most people are now coming to understand the limitations/failure of existing AIDS treatments. Johnarchives.theglobeandmail.com Scientists to study why AIDS drugs fail ANDRÉ PICARD PUBLIC HEALTH REPORTER Wednesday, March 21, 2001 Western researchers are scrambling to determine why drug cocktails are failing for up to half of patients with HIV-AIDS. "The latest AIDS drugs have been a quantum leap forward, but regrettably many people are starting to lose the benefit of these drugs," said Dr. Alan Berstein, president of the Canadian Institutes of Health Research. He said there is an urgent need to "address the increasingly pressing question of how to best treat people for whom all our available drug cocktails have failed." Today, researchers will unveil plans for a massive international study to do so. The four-year, $15.3-million (U.S.) project is a collaboration between the CIHR, the U.S. Department of Veterans Affairs, and the Medical Research Council of the United Kingdom. The so-called Optima (options in management with antiretrovirals) study is the first under an unprecedented, three-country research initiative, which has been likened to a scientific free-trade pact. In particular, researchers will examine the benefits of drug holidays -- suspending antiretroviral drug treatment for three months to allow patients to recover from side effects, and which may leave them more susceptible to renewed attack. They will also evaluate whether existing drugs can be used more effectively in new combinations, and the cost-effectiveness of drug cocktails. In 1996, the medical world was rocked by research indicating drug cocktails could probably eradicate HIV from a person's body within three years. Today, there is a realization that, even at undetectable levels, HIV can hide in reservoirs. Further, the most potent antiretroviral drugs -- even in combinations of up to five drugs -- cannot entirely prevent the wily AIDS virus from reproducing. So, while drug cocktails have cut the death rate by almost 70 per cent in developed countries like Canada, researchers now recognize that they will have to be taken over the long term, and that has important implications because so many of the drugs have serious side effects. The drug cocktails require adherence to a strict schedule, which explains, in large part, the high failure rate. An estimated 50,000 Canadians are living with HIV-AIDS, a fraction of the 34 million people worldwide who are infected. The Optima study will be conducted at 22 hospitals in Canada, 25 in Britain and 30 in the United States.