On March 19, 1987, the Food and Drug Administration announced that AZT had been approved for use as an antiretroviral drug, the first drug approved to combat HIV. This past week, the FDA made another, perhaps equally important, announcement regarding HIV medications. On July 12, 2006, the FDA announced that Atripla, a once a day antiretroviral drug cocktail, had received approval.
Since the approval of AZT as an antiretroviral drug in 1987, the FDA has approved a number of drugs to combat HIV. Today, approximately 20 drugs are available to combat this virus. These drugs include nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and a fusion inhibitor. And since the mid-1990s, it has been clear that combinations of these drugs are more effective at decreasing the viral load in people with HIV than are drugs taken individually. Rather than taking a single drug, monotherapy, people with HIV take multiple drugs. Currently, the recommended therapy involves three different drugs, usually two nucleoside reverse transcriptase inhibitors and a protease inhibitor.
This highly active anti-retroviral therapy, or HAART, is very effective, though not without its problems. One of the major problems associated with HAART has been the difficulty people with HIV have in adhering to the drug regimen. The standard regimen often requires that people take multiple pills at different times of the day. Failure to comply with this complex regimen can result in a rise in a person’s viral load and the development of drug resistant viral mutants.
Atripla may eliminate this problem. Atripla consists of a non-nucleoside reverse transcriptase inhibitor – efavirenz, manufactured by Bristol-Myers Squibb – and two nucleoside reverse transcriptase inhibitors – tenofovir and emtricitabine, manufactured by Gilead Sciences. The recommended dosage is a single pill, taken once a day. The wholesale price is roughly $1100 for a one month supply. More information about Atripla can be found on the AIDS Meds website at www.aidsmeds.com/drugs/Atripla.htm.
The cooperation of these two pharmaceutical companies should be applauded. This new drug combination represents a major advancement in the treatment of HIV. And if Atripla becomes available in developing countries, at a nominal cost, then we can really cheer.