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HIV and AIDS

Questions Pertaining To Protease Inhibitors And Pandemic Flu

03/21/2005

Question:

Pandemic Flu and Protease inhibitors H5N1 Bird Flu may be treatable with Kaletra. http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2005-03-01T162045Z_01_B682054_RTRIDST_0_HEALTH-BIRDFLU-AIDS-DC.XML

What other Protease inhibitors may work against a pandemic Flu? Could children be safely treated with these drugs? Could rich countires stockpile these drugs as an insurance policy against pandemic flu? Could the stockpile then be donated to poor Nations for AIDS treatment before the drug expires?

Answer:

I will answer the questions in reverse order. The issues of stockpiling medicines and donating them to poor countries are public policy questions more than medical care questions. Governments and their designated public health authorities need to determine the need, value and logistics of any medication stockpile. I am not aware of any current plan to stockpile HIV medicines such as protease inhibitors. Furthermore, poorer countries have access to inexpensive HIV medicine produced off-patent by Indian pharmaceutical companies. Children with HIV are already treated with protease inhibitors. The question that you did not ask is: DO HIV protease inhibitors really work against avian influenza? The article that you cite doesn't say that they really do. It says that a researcher says that HIV protease inhibitors MAY work against influenza. Thinking that a medicine MAY work is very different than knowing that it DOES work. If and only if HIV protease inhibitors are PROVEN to work against avian influenza can governments then decide whether or not to stockpile them in preparation for avian influenza. Medicines that do work against avian influenza are zanamivir (Relenza) and oseltamivir (Tamiflu), which are used for the treatment of human influenza. the following question was assigned to you:

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Response by:

Amy Beth Kressel, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati