The names saquinavir, indinavir and ritonavir may not mean much
to most people. But these new drugs have drastically changed the
way AIDS is managed and have allowed thousands of patients to make
Called protease inhibitors, they stop the AIDS virus from
replicating in the body, and today some patients who were seriously
ill have almost undetectable levels of the virus in their blood.
Along with this good news about AIDS comes a downside: the grim
stories of those who haven't been helped and a concern that people
may be returning to unsafe sex practices, thinking that doctors
have found a cure for the disease.
"I feel let down," said a 42-year-old man from St. Louis. "I
guess it is just my luck."
The man, a carpenter and the father of two teen-agers, received
a diagnosis of AIDS almost 10 years ago. He was doing quite well
until the week before Christmas when he was hospitalized for
lymphoma, cancer of the lymph nodes.
He's tried all the available protease inhibitors and even two
in combination. But none has helped him.
"The media have overplayed" the advantages of such drugs, said
the man who asked that his name not be used. "They don't work for
That's something that more and more physicians are discovering
in St. Louis and nationwide. And they worry that people may
mistakenly think the AIDS scare has ended.
The disease remains the leading cause of death among men ages
25-44 and the third leading cause of death among women ages 25-44
in the United States.
Mark Pickering, executive director for the St. Louis Effort for
AIDS, said: "We have concerns about people who think they don't
have to take precautions now because it is over. They think, `I
will just take a pill, and it will be all right,' and it is not
The message about the need to practice safe sex has been
overshadowed by the dramatic stories surrounding protease
inhibitors, Pickering said.
These drugs were rushed to the market and approved for
commercial use by the Food and Drug Administration in record time
because of their dramatic results. Some patients literally went
from their deathbeds to what appears to be a complete recovery.
Patients experienced a dramatic lowering of the amount of virus
in their blood, said Dr. William Powderly, who's with the AIDS
Clinical Trials Unit at Washington University School of Medicine.
The virus isn't even detectable in some patients.
Powderly and many other infectious disease experts agree that
protease inhibitors have made a dramatic improvement in the way
AIDS is managed. …