HIV Digest	HIV Digest Archive

Three new drugs are currently available in expanded access programs-- abacavir (formerly known as GW1592), adefovir (Preveon), formerly known as bis-POM PMEA and GS 840) and efavirenz (Sustiva, formerly known as DMP-266).

Although initial programs for these drugs are very small and constrained by limited drug supplies, they will soon be expanded to provide access to a wider group of people.

Efavirenz

This drug is a highly potent non-nucleoside arialogue reverse transcriptase inhibitor (NNRTI), the same class of drug as nevirapine (Viramune) and delavirdine (Rescriptor). Although only preliminary information is available, the drug has shown fairly remarkable activity when used in combination with indinavir (Crixivan). Additional clinical trials are studying its use in combination with a wide variety of other drugs, including AZT plus 3TC, other protease inhibitors, and combinations employing one each of all three classes of drugs. Perhaps the most remarkable quality of efavirenz is that it remains stable in the body longer than almost any other currently available AIDS therapy. This quality permits the simplicity of once-daily dosing.

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The initial efavirenz program was limited to people with fewer than 50 CD4 cells with a history of failure on current regimens. The first stage expansion of the program extends the CD4 cell limit to 200. The final stage of the program, if agreed to by the Food and Drug Administration, will eliminate CD4 cell limits. For more on the efavirenz program call 800-998-6854.

Abacavir

This widely discussed drug, formerly known as GW1592, is a highly potent nucleoside analogue. It's highest level of potency, however, is limited to people who have not previously used other drugs of this class. New data shows that in general, the more drugs of this type a person has previously used to the point of failure, the less likely it is that this drug will work. Thus, its role will be limited, even though it is likely to make an excellent choice for first-time therapy.

The current program for abacavir is limited to people who have CD4 cell counts below 100, a viral load above 30,000 copies HIV RNA and who have failed at least one protease inhibitor regimen. The expansion of this program in early 1998 should at the very least remove these restrictions and make the drug widely available to people who need it to build an effective combination. For information on the program call 800-501-4672.

Adefovir

This is a nucleotide analogue which blocks HIV replication at the same stage of the virus life cycle as the nucleoside analogues and is dosed once daily. Results from earlier studies show modest anti-HIV activity when used alone. It is not known how well people who have failed on existing nucleoside analogue therapy will respond to adefovir. This drug also has activity against hepatitis B virus and cytomegalovirus (CMV)-- however it is unlikely that adefovir can be used to treat CMV, although it may be effective in preventing the disease.

The current program is limited to those who have CD4 cell counts below 50, a viral load above 30,000 copies HIV RNA and who have failed or are intolerant to a combination regimen containing two nucleoside analogues and a protease inhibitor. For more on the program call 800-445-3235.

Editor's Note: from Project Inform's Perspective