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Fusion inhibitor answers (86)

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Q: 

What are fusion inhibitors?

A: fusion inhibitors are drugs which are designed to prevent the Human Immunodeficiency Virus (HIV) from entering cells. The goal of this class of drugs is essentially to head the virus off at the pass, attacking it before it gets a chance to attack the body. These drugs, also known as entry inhibitors, are designed to be used as part of HIV combination therapy, which means that they must be used with other antiretroviral drugs in order to be effective. The way in which fusion inhibitors work is fairly simple. In order to replicate in the body, HIV needs to attach itself to human cells and hijack their normal routine, forcing them to produce clones of the virus...


Q: 

fusion inhibitors and clinical trials.

A: Response from Dr. Pierone I think that your primary ID doctor is correct. A simple regimen would probably work as well with fewer side effects. fusion inhibitors require daily injections and are no walk in the park. If you do decide to participate in this trial you should realize that it would be to advance medical science, personal benefit would not be high up on the list. Thanks for posting and good luck....


Q: 

When to Jump to New Virus Entry inhibitors

A: Response from Dr. Pavia Great question, and I am glad you had a chance to hear the talk on viral entry by Robert Doms. It was a phenomenal talk in person, and I am glad it is available on the net. It is a safe bet that HIV will develop escape mutants to almost any approach if one drug is used alone and if it does not completely suppress replication. We keep hoping we have found a target that cannot mutate, but that is certainly not true for the fusion domain, the target of T20 and T1249. It looks as if using CD4 or CCR5 inhibitors with T20 type drugs will be a very potent combination. The capsid zinc finger is a very small molecule that may not be able to mutate much, but we are still a ways from having a zinc finger

Q: 

INtergrase inhibitor Drug Trial

A: Response from Dr. Young Thanks for your question and participation in clinical trials. HIV integrase is a HIV-encoded protein that is essential for the life cycle of the virus. The enzyme (integrase) is responsible for inserting the genetic material of HIV into the human chromosome. Because the enzyme has no human counterpart, it is an attractive target for drug discovery. Until recently, there have not been compounds that could be tested in humans. Recently, two groups, one from Merck and another from a joint program- Shionogi-GSK have announced candidate compounds that inhibit the HIV integrase in vitro. The Merck compound is still in early development, the Shionogi-GSK compound (called S-1360) is now entering Phase II clinical trials-- trials designed to establish the correct dose of...


Q: 

Proton-pump inhibitors may weaken bones

A: What exactly is a proton pump inhibitor? What is it used for? Its those drugs like Nexium and Prilosec used for acid reflux (which I bet alot of us use due to the Nsaids killing our stomachs! You are right SKZ, I stopped taking my "stomach pills'' as soon as I read the article and I am eating antacid pills by the handfuls. They don''t work nearly as well but broken hips and failed fusions scare me more. I know it''s early in the discovery stage but where are the answers found? Is taking nexium or prevacid hurting our bones? I wonder if Zantac (aka Ranitidine) is also in that catagory? I am thinking it isnt, but am not sure....


Q: 

fusion and entry inhibitors

A: Response from Dr. Young Thanks for your question. fusion (or entry) inhibitors should make their debut in the near future with the release of enfuvitide (nice name, huh--otherwise known as Fuzeon or T-20). The class of medications is exciting from the perspective that many persons with drug resistance should retain full activity of the new class. Unfortunately, the drug is very expensive (~$20,000/yr), requires twice daily injections and needs to be taken with at least a couple of other HIV medications. Is it less toxic? The large investigations of the drug have shown it to be relatively well tolerated, with the exception of injection site allergic reactions. As for future medications, this remains the realm of speculation, since what we''d...


Q: 

A few questions......

A: Response from Dr. McGowan Thanks for your post, I am glad you have maintained an undetectable viral load back on treatment. The drug(s) that are most vulnerable when treatment is stopped are those that are cleared most slowly from the nblood, which would be the NNRTI (Sustiva). The drug must be present in the blood for it to select resistant virus from the mixture of virus in the body. Spread of HIV from cell to cell (called syncytia formation) has been observed in the laboratory in cultures of T cells outside the body (in vitro) for many years. The extent that T cell fusion occurs inside the body (in vivo) is not clear. The process of cell fusion occurs through viral interaction with co-receptors on the T cell surface (CCR5 or CXCR4) and...


Q: 

on the horizon

A: Response from Mr. Kurtyka Alex, As you know, the only fusion inhibitor currently approved by the FDA is Fuzeon. Entry inhibitors are part of a bigger classification of drugs called entry inhibitors which also includes attachment inhibitors, CXCR4 inhibitors and CCR5 inhibitors. There are quite a few agents in these categories that are in various stages of clinical trials. Attachment inhibitor agents in trials include BMS-806 and TNX-355. There are two types of chemokine receptor inhibitors with several agents in various stages of clinical trials: CXCR4

Q: 

What Is Going on?

A: Response from Dr. Cohen Sure Thing. You have listed the research agenda for many of us for these coming years. There are new fusion inhibitors, integrase inhibitors, new generation nonnucleosides, and so on. So what''s the holdup? Well, it turns out that a few of the meds you ask about are in fact pretty close to becoming available. The reason however you can hear about promising new drugs, and then wait for years before someone can use them, is that we have in the US and Europe a multiyear process of testing meds prior to allowing them for sale. And this process occurs in stages. So let''s take for an example the fusion inhibitor T20. About 4 years ago a few people...


Q: 

Recognizing the virus

A: Response from Dr. Young Thanks for your question(s) and comments. I agree that entry and fusion inhibitors are very exciting aspect to future strategies to treat HIV. There is much more than just stopping the virus in having an effective, long-term HIV treatment, never mind an eradicative therapy-- so much so, that I would hesitate to bet on what role the current batch of entry and fusion inhibitors will play. Stay tuned, though, I know that the pipeline is robust and will deliver a lot of new data. BY...


 
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