Erika, I’ve been fulminating all week about how AIDS differs from other medical conditions. Well, here’s one way in which they are the same: drug therapy is the cornerstone of treatment.

At the 1996 Vancouver conference, articles in the first issue of the conference newspaper noted that three-drug combinations reduced viral load and death of HIV-infected patients. These combinations included two types of drugs: protease inhibitors (PIs) and reverse transcriptase inhibitors. Combining the two types of drugs changed HIV from a death sentence to a chronic disease, and opened up a tantalizing possibility: “Can combination therapies eradicate HIV?” the conference newspaper asked.

Many new and improved PIs have been introduced in the last ten years, but today’s first-line regimens use the same two classes of drugs as those initial combinations. Six of the 18 late-breaking reports presented at this year’s meeting simply evaluate new ways of using those drugs.

Already at the 1996 meeting, emergence of drug resistance stimulated one scientist to warn that new drug classes were needed. Only this year is that happening. Five late-breakers reported on early tests of compounds that inhibit a viral protein called the integrase, and two proteins that help the virus attach to cells in the body. Basic research reported here also raises the possibility that inhibitors of another viral protein – Vif – may eventually prove useful.

Will any of these potential drugs be as potent as existing agents? Will combinations that inhibit three viral proteins be even more effective than current regimens? Hopefully we won’t have to wait another ten years for the answers.