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The story behind the first anti-AIDS drug

Nowadays, if someone is diagnosed with HIV, he or she can choose from 41 medicines that can treat the disease. And there is a good chance that with the right combination, given at the right time, HIV drugs can keep levels so low that one never gets sick.
That was not always the case. It took seven years after HIV was first discovered before the first drug approved by the Food and Drug Administration of the United States approved the fight (FDA, for its acronym in English). In these early years of the epidemic anxious millions of people infected. Only a few thousand died on the hour, but public health officials competed, which the tips to maintain mortality - when people who tested positive, not treated with the inevitable result of something.

As it had turned out, its first weapon against HIV was not a new compound, scientists from scratch to develop the new, was one that was already on the shelf, but abandoned. AZT or azidothymidine, was originally developed in the 1960s by an American researcher as a way to prevent cancer; The compound is to be inserted into the DNA of a cancer cell and its ability to interfere replicate and produce tumor cells. But this does not work when tested on mice and has been put aside.

Two decades later, caused by AIDS as a new infectious disease, the pharmaceutical company Burroughs Wellcome, known for its antiviral drugs, a huge test of potential anti-HIV agents, to find in the hope of something that may work against this new virus began -enemy. Compound something S was among the items tested called a version made re-do of the original AZT. When it was released on a plate with cells coming from animals infected with HIV is to block the activity of the virus appeared.

The company sent samples where they directed the agency understood the importance of the discovery of the FDA and the National Cancer Institute, Dr. Samuel Broder. But that was not enough to have a compound that could work against HIV. To make it available for the estimated millions that were infected, the researchers had to make sure it was safe and actually stop HIV in some way, but not to cure people of their infection. At the time such tests, a supervised by the FDA, increased from eight to 10 years.
Patients could not wait that long. Under enormous pressure from public opinion, the FDA's review of AZT has quickly said some to the detriment of patients.

Scientists have quickinjected on AZT patients. The first objective was to see if it was safe, and although it causes side effects (including serious intestinal problems, damage to the immune system, nausea, vomiting and headache) was considered relatively safe. But they had to prove the efficacy of the compound. For this purpose, a controversial study is diagnosed with about 300 people, who had started with AIDS. The plan was randomly participating capsules agent or a sugar pill for six months assign to accept. Neither the doctor nor the patient would know if they were on the drug or not.
After 16 weeks, Burroughs Wellcome announced that the study was halted because there was strong evidence that the connection seemed to work. One group had only one death. Even in this short time, the other group was 19. The company argued that it would not be ethical to deprive the trial and to continue a potentially life-saving treatment group.

                                  The photo that changed the face of AIDS

These results were announced and AZT as a "breakthrough" and "light at the end of the tunnel" for the company, and pushed the FDA the first AIDS drug on March 19, 1987, on a record to be approved 20 months.
But the study remains controversial. The reports came shortly after the results were distorted to light because physicians were not provided with a standard form of treatment of other problems associated with AIDS available - pneumonia, diarrhea and other symptoms - be it AZT it was intended only responsible almost impossible for results Dramatic. So there were some transfusions of blood patients to help their immune system; Could have the introduction of new, healthy blood and immune cells in these patients helped to fight the virus better. There have also been reports of patients from 12 centers where the study was conducted combining their pills to improve the odds of at least getting a portion of the drug and not just placebos.

And there were still many unanswered questions about the drug when it was approved. How long have the benefits obvious? Could people who were not sick or benefit? Have you benefited more later in your illness?
This uncertainty would go to a traditional license not to be acceptable, but the urgent need to have something on hand for the growing epidemic forced to fight side by the FDA. People in the study were already drug simply pressureing rid of the company and the FDA - if there was anything that would work against HIV, then they said it was unethical to withhold.

Drug approval is still controversial, but in a world where treatment options are so advanced that it can be difficult, the sense of urgency and social pressure, imagine that the medical community penetrates at the moment. AIDS was an imminent wave, which wanted to bring to the margins of an unsuspecting population to fail - and, unfortunately, surprise -. Having at least one drug that, although limited worked, was seen as a progress.

But even after the approval of AZT, activists and public health officials are worried about the price of the drug. About $ 8,000 a year (over $ 17,000 in today's dollars) - was prohibitive for many uninsured patients and AIDS advocates accused Burroughs Wellcome of a patient population already vulnerable to exploitation.

In the years since it has been found that each drug is the HIV response. People taking AZT soon began to show levels of virus to increase - but the virus was not the same, they are mutated to resist the drug. More medications are needed, and AIDS lawyers have criticized the FDA for not moving additional drugs fast enough to be approved. And the side effects, including heart problems, weight problems and people remembered that all developed a virus like HIV was to combat toxic.

Today, there are several classes of HIV drugs that block each designed virus at certain points in its life cycle. Combined, they have to maintain the best opportunity in the HIV bay, in which the virus's ability to replicate and infect, and ultimately lead to death. These so-called antiretroviral drugs have made it possible for him to diagnose people with HIV live long, relatively healthy lives while continuing to take drugs. And for most of these people, their therapy often AZT.

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