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August 28, 1996

New HIV Drugs Cast in Supporting Roles

JAMA. 1996;276(8):585. doi:10.1001/jama.1996.03540080009003

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THEY MAY NOT pack the punch of protease inhibitors, but non-nucleoside reverse transcriptase inhibitors appear to have a promising future as a niche drug in the treatment and prevention of HIV infection.

During the XI International Conference on AIDS in Vancouver, British Columbia, researchers said the drugs will be useful in a variety of scenarios, from playing a role in combination therapy to serving as a potential "morning after" pill to prevent infection following unprotected sex.

"There is something special about these drugs," said Joep Lange, MD, professor of internal medicine at the Academic Medical Centre, University of Amsterdam, The Netherlands.

Direct Inhibition  The non-nucleoside drugs are similar to nucleoside analogs like AZT (zidovudine) in that they change the function of reverse transcriptase (RT), an enzyme that HIV needs to replicate. However, the non-nucleoside drugs do not have to be activated by cellular enzymes. And while inhibitory mechanisms of nucleoside