HIV Digest	HIV Digest Archive

Preliminary data suggest Merck & Company's MK-0518, an integrase inhibitor, reduces HIV in treatment-naive patients' blood more quickly than standard treatment, said researchers at the 16th International AIDS Conference. An integrase inhibitor works to prevent HIV from integrating with the host cell's DNA in order to replicate.

The integrase inhibitors "really look fantastic, with very few side effects," said Dr. Mark Wainberg, a McGill University professor and conference co-chair. Researchers said the new class of drug was the most encouraging development since fusion inhibitors were approved by the US Food and Drug Administration (FDA) three years ago.

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n an earlier trial, MK-0518 was combined with tenofovir and lamivudine in treatment-experienced patients with multiple drug-resistant HIV. After 16 weeks, as many as 72 percent of patients had undetectable viral loads.

In the new study presented at the 16th International AIDS Conference, a cocktail of MK-0518 plus two other drugs was matched against those same two drugs plus efavirenz among 198 patients recently starting treatment. The patients took MK-0518 in doses from 100 milligrams to 600 milligrams twice daily. The control group took 600 milligrams of efavirenz once daily. At all doses, the MK-0518 group suppressed HIV faster than the efavirenz group.

However, at the end of 24 weeks, the efavirenz and MK-0518 combinations were performing about the same, said Dr. Robin Isaacs, who led the study. MK-0518 has several years of testing before it reaches the FDA for review.

Merck has announced an expanded access program for the experimental use of MK-0518 among patients unable to participate in a clinical trial. Expanded access programs are a mechanism for offering experimental drugs to patients with life-threatening illnesses who cannot be effectively treated with existing drugs. Enrollment in the program will begin in the next few months.

from the Los Angeles Times