AIDS: The End of Inhibitors?

TORONTO: Could patients be developing an immunity to parts of the chemical cocktail that has proven so effective in fighting HIV? The announcement to this effect by Dr. Steven Deeks, a University of San Francisco AIDS researcher, that people might be developing an immunity to the protease inhibitors Crixivan and Norvir has left many questioning whether the highly-expensive treatment would remain worthwhile. A study of 136 HIV-positive people who started using the inhibitors in March of 1996 showed that within a year the virus had returned to detectable levels in about 53 percent.

But many doctors question Deeks' results, says TIME's Christine Gorman, noting that his survey is based on an incomplete analysis of the HIV levels in the subjects. Equally important, the study doesn't take into account whether all the patients were actually following the rigorous and demanding pill-popping regimen that the chemical cocktail demands. Up to 20 pills a day must be taken at specific times, and doses must be calibrated to the individual. Since each individual responds differently to the medication, it's difficult to determine whether the drugs are in fact losing their effectiveness or if people aren't following their prescription. "What this shows once again is the complexity involved in tailoring these treatments to the individuals," says Gorman. "Not everyone can keep up with the demands of this."