March 2002
New Medications in the Wings !
(especially for those of us that are resistant)

By Eric Jean Rocker

There is a totally new class or kind of medication being developed. This new kind of medication is called a “fusion inhibitor” it works by effectively blocking the HIV virus from getting into our cells. This helps to save our cells from being destroyed and makes the HIV unable to reproduce itself. The new medications in development are T-20 and its daughter T-1249, both are still in the trials. But are really looking good!

The positive things about these new medications are:

1. These meds are active against strains of HIV that have built up resistance to other drugs. (Good news for those of us who are considered salvage patients.)

2. There is no cross-resistance to these drugs because they work in a totally new area of the virus cycle and in a new way than the older medications do.

3. T-20 has shown the ability to dramatically reduce viral load when combined with other antiretroviral therapies.

4. This helps protect our CD4 cells as they are produced, hopefully allowing our CD4 numbers to rise. (CD4s are our soldier or fighter cells)

5. One of the best aspects of these kinds of meds is that there are very few and minimal side effects.

6. Also there is evidence that unlike other classes of drugs, if you build resistance to T-20 there is no cross resistance to T-1249.

The negative aspects of these medications are:

1. it is very difficult and time consuming to produce T-20.

2. Making it very expensive and only limited amounts can be produced at this time.

3. These drugs are destroyed by the digestive track and must be absorbed into the fatty layer just under the skin. This means it has to be a subcutaneous injection. (A shot similar to the ones diabetics give themselves).

4. With T-20 you must give yourself a shot twice a day. You also need to have the special needles and a biohazard disposal box that they give you in your home (not easy to hide all this stuff from others, so it can be difficult if you haven’t disclosed your status).

5. The only side effects to date have been irritation at the injection sights (reddish slightly itchy spot that goes away in a few hours).

6. The T-20 must be refrigerated until you are ready to use it.

It appears that some of the negative aspects of T-20 have been reduced or simplified in the T-1249 medication. It appears easier to make and hopefully cheaper as well. The T-1249 may be a once a day injection instead of twice. Also some data suggests that there is synergistic activity between drugs of this kind. That means that they may work better together than they do alone. If you are a member of the “salvage therapy” crew, keep your eyes and ears open for the availability of these meds, they may be real life savers!

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