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The use of dual protease inhibitor (PI) therapy was highlighted recently at the Interscience Conference on Antimicrobial Agents and Chemotherapy in Toronto. Among the researchers touting the treatment was Dr. John Mellors, head of the HIV/AIDS program at the University of Pittsburgh, who reported several benefits from using two PIs in drug therapy instead of just one. Mellors also forecast that dual use of the drugs would become the preferred standard of care next year.

Dr. John Bartlett, of Johns Hopkins School of Medicine in Baltimore and chair of the committee that developed the guidelines, contends that the use of dual PI therapy should be expanded to patients in earlier stages of infection. He also said that there should not be so much concern about using such potent drugs early on.

The most common and widely studied combination of protease inhibitors is ritonavir and saquinavir. According to a Canadian study of the two drugs, patients who had no previous protease inhibitor therapy were 4.5 times more likely to suppress their viral load than those who had used a PI in the past. Another study found that 90 percent of 114 PI-naive patients who took ritonavir/saquinavir therapy had undetectable plasma levels after about 12 months.

Editor's Note: from AIDS Alert