Is cross-resistance between protease inhibitors a real concern?
There is very little information available about cross-resistance. The few published reports describe results of small numbers of test-tube studies and even smaller numbers of blood samples taken from people who have used protease inhibitors. Furthermore, the different manufacturers seem to disagree about the cross-resistance of their products. For example, Roche says its product saquinavir is not cross-resistance to Merck’s product indinavir. Merck, on the other hand, insists that saquinavir is indeed cross-resistant to indinavir. Larger studies conducted by independent laboratories are urgently needed so that people can make rational decisions about their treatment regimens. • When to start? Many researchers are now strongly suggesting that people base their decision to start antiretroviral therapy on their viral load measures. However, there is no clinical data available to support or refute starting treatment with protease inhibitors when CD4+ counts are above 500 cells. Members of
