UK patients to get new HIV drug

HIV can become resistant to treatment

The first in a new class of HIV drugs has become available in the UK.

It means doctors will have a further treatment option for patients who have built up resistance to existing drugs.

Raltegravir is an integrase inhibitor, which works by blocking an enzyme essential for HIV to be able to replicate itself.

An estimated 73,000 people live with HIV in the UK. Raltegravir will be reserved for those who have stopped responding to other treatment.

Resistance to HIV medication is becoming increasingly common - more than one in 10 UK patients with HIV has some level of resistance to at least one drug before they have even begun therapy, research has shown.

A clinical trial of Raltegravir published last year found it to be effective in patients who had been taking regular antiretroviral HIV drugs for about 10 years.

The more ways we have to attack the virus, the more chance we have of successfully managing the disease Dr Mark Nelson, Chelsea and Westminster Hospital

Treatment for HIV is helping people to live longer but, in the UK, one of the biggest challenges is the threat of resistance.

Integrase is one of three HIV enzymes the virus uses to multiply.

It inserts viral genes into the DNA of the host cell, effectively making it a "factory" for producing more of the virus.

Without this, the virus cannot multiply and infect other cells as easily, reducing the amount of virus present in the blood.

Mutation

Dr Mark Nelson, director of HIV services, at Chelsea and Westminster Hospital, London, said the drug would be used in a small proportion of patients as part of a combination of drugs.

"HIV is a clever virus which adapts and mutates quickly, producing drug resistant strains of the virus.

"The more ways we have to attack the virus, the more chance we have of successfully managing the disease.

"But we've got to be smart about how we use these new drugs - we don't want to repeat past mistakes where resistance arose from using single therapies."

Roger Pebody, treatment advisor at the Terrence Higgins Trust, said the drug would be useful for as many as 10% of people currently on treatment.

"This is excellent news for people who are resistant to other HIV drugs.

"A combination of drugs is used to stop HIV at different stages of the process of entering and destroying the body's immune cells.

"If someone becomes resistant to any of their drugs, their treatment needs to be changed, and drugs which work in innovative ways can make a real difference."

Professor David Back, an expert in pharmacology at the University of Liverpool said the drug would be "extremely useful" in some patients.

"Patients are remaining healthy for an extended period of time and there is a percentage who will fail therapy."

He added that, if patients became resistant to one drug within a class, they could be resistant to others within that class even if they had never taken them before.

"It provides another option."