Monthly Update: Biologicals & Immunologicals: New drugs for the treatment of HIV infection

Abstract

Treatments of HIV infection can be divided into two major categories: 1) drugs that are active against the HIV virus itself; and 2) drugs that are used to treat the opportunistic infections (and malignancies) which are often the main cause of death. Drugs in the latter category have become so effective, especially when used for prophylactic treatment, that patients are now surviving some years with few or no CD₄ cells, only to develop complications which cannot be treated prophylactically. One of the most interesting of these is the rising incidence of non-Hodgkin's lymphoma which appears to be almost inevitable if patients are kept alive and infection-free for long enough. To these two major categories, a third should be added. This includes those drugs which attempt to alter the immunological response to the virus and the cytokine milieu, both of which would appear to be associated with differential rates of progression to disease. In this article, before moving onto potential candidates for inducing some of these changes, I will briefly review some of the advances in anti-HIV therapy which suggest that this ‘third’ category approach to HIV infection is necessary.