New HIV drug adds to medical arsenal, but still no quick fix

    A new HIV drug, Tivicay, will hit the market this month following its approval by the Food and Drug Administration.

    It was developed by ViiV, a joint venture of GlaxoSmithKline PLC and Pfizer Inc., both companies with a big presence in the Delaware Valley.

    Tivicay joins a newer drug class that blocks an enzyme involved in the replication of HIV in one’s body. Untreated, HIV can attack immune systems, making patients susceptible to serious, fatal infections.

    A new option

    Area doctors who specialize in treating HIV welcome the new drug, intended for newly infected and long-term HIV patients. They caution, however, that it’s no quick fix.

    Dr. Kathleen Squires, director of infectious diseases at Thomas Jefferson University Hospital, wasn’t involved in the drug’s development but said she thinks it’s promising for patients, especially those few who are resistant to similar types of drugs.

    “It’s exciting to see a new drug on the market in terms of really being able to individualize care for HIV-infected patients and to give them an array of options based on the number of pills a day, side effects from the drugs, and being able to show how well they’re able to suppress their infection,” Squires said.

    Dr. Karam Mounzer, clinic director of the Jonathan Lax Treatment Center in Center City Philadelphia, was a principal investigator on three studies involved in the development of the drug.

    “It is a welcome addition,” Mounzer said. “You want a simple regimen that is well-tolerated, that you know will suppress a virus, and that you know if the patient skips a dose here and there, you don’t want the regimen to select resistance.”

    Part of what makes Tivicay appealing, he said, is its prospects of being combined with other medications into one pill, taken once a day, down the road.

    Dr. Jody Borgman, director of the Immunodeficiency Clinic at Einstein Medical Center, agreed, saying that would give patients another easy treatment possibility. That ease can help assure adherence to the treatment, an important determinant in how well a drug actually works.

    “New drugs aren’t always the issue,” Borgman said. “It’s finding drugs that patients will take.”

    Not a game-changer

    In the late ’90s and early 2000s, there was just one HIV drug available, and it may not have been that effective for patients over time. That has since changed, with more than two dozen HIV drugs available today.

    “We’ve gotten better drugs that people can tolerate better,” Borgman said. Earlier medications had more side effects and had more complicated treatment schedules, leading to missed dosages and more drug resistance.

    The regimens have gotten a lot simpler, going from multiple pills multiple times a day to one to three pills one or two times a day.

    “We certainly have a lot of options,” Borgman said. “We can definitely get by without this” new drug.

    Underlying challenges

    There are several other factors, beyond drug options, in assuring the long-term health of an individual with HIV, according to Borgman and others.

    Dr. Robert Gross, an HIV researcher at the University of Pennsylvania who treats patients at the Philadelphia VA, said other health services and behavioral issues “are actually more in the forefront in my mind and most other HIV providers.”

    Gross said bigger challenges to ensuring people with HIV stay healthy include identifying who’s infected and encouraging people to get tested for the virus. Battling the stigma associated HIV continues to be an issue, he said, as is successfully connecting people with continued care.

    According to the city health department, about 19,000 people are living with HIV/AIDS in Philadelphia.

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