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Injectable Drug Helps HIV Suppression

Drug Doubles Chance of HIV Suppression, but Many Afraid of Self-Injection
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WebMD Health News

July 12, 2004 (Bangkok, Thailand) -- Four years ago, Richard Apodaca, an AIDS patient in San Francisco, had given up hope.

"I was taking as many as 60 pills a day and I still couldn't walk, never mind work. HIV had completely decimated my immune system," Apodaca tells WebMD.

But when he told his doctor he didn't want to go on anymore, his doctor asked him to join a clinical trial of an experimental medication, now known as Fuzeon. The treatment, he says, "gave me my life back."

"After beginning treatment with Fuzeon, my energy returned. My HIV levels became undetectable." The 61-year-old says he now has so much energy that he regularly runs marathons.

So why aren't all AIDS patients considering adding Fuzeon to their treatment regimen?

The main reason, doctors tell WebMD, is "injection paranoia." Just like people with diabetes who must inject themselves with insulin several times a day, people with HIV have to inject themselves with Fuzeon twice a day, while continuing on their regular antiviral medications.

But the rewards are great, says Calvin Cohen, MD, medical director of Harvard Vanguard Medical Associates in Boston.

Fuzeon is the first of its kind; it is known as fusion inhibitors and is always taken with other anti-HIV medications. Unlike other anti-HIV medications Fuzeon helps fights HIV outside CD4 cells. It blocks HIV's ability to infect healthy normal cells. Other anti-HIV drugs work after HIV has already entered (infected) the CD4 cell.

Reporting here at the XV International AIDS Conference, Cohen says people with HIV who use the medication can double their chances of suppressing the amount of HIV in the blood to undetectable levels compared with people taking anti-HIV medications without Fuzeon.

"Within just three months, patients taking Fuzeon are twice as likely to [wipe the virus out of their blood] as those who are not taking the drug," he says.

And by two years, 26% of patients on Fuzeon plus their usual anti-HIV medications had undetectable viral levels, compared with 13% of patients who were not taking Fuzeon, says Cohen, an investigator in the T-20 vs. Optimized Regimen Only (TORO) study.

Yet despite Fuzeon's benefits, four of 10 eligible patients are not even offered the drug, he said. "And of the other six, three patients reject the drug because they don't think they can inject themselves," he says.

But contrary to common belief, the vast majority of patients do not view the injections as a hurdle once they become aware of the drug's benefits, Cohen tells WebMD.

In a new survey, 67% of patients said the drug was "very easy or easy to use," with only 19% finding it difficult to use, he explains.

"Patients taking Fuzeon find it much easier to inject themselves than people who haven't tried it think they will," he said at a press briefing.

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