Antiviral drug development for the treatment of human immunodeficiency virus infections. An overview.

During 1987, a new era in the approach to treatment of severe human immunodeficiency virus (HIV)-I infections was entered. The increased availability of zidovudine and its licensure in many countries have resulted in its widespread use. With these developments have come a multitude of new questions. How long will clinical benefit be sustained? Will zidovudine be useful in asymptomatic HIV carriers and in other HIV-related conditions? How can the diversion of zidovudine to unproven indications be averted so that properly controlled clinical trials are conducted? Can better treatment regimens be developed to enhance the therapeutic/toxic ratio of zidovudine? What are the proper roles of governments in assuring patient access to zidovudine? How should newer anti-HIV drugs be compared with zidovudine? Will combinations of zidovudine and other active agents be useful? To address many of these issues in the United States, the Federal Government has established an AIDS Clinical Trials Group (ACTG) program. Over 3,000 patients have been enrolled in AIDS Clinical Trials Group trials, which span the spectrum from asymptomatic to advanced HIV-I infections. In addition, drug development and screening programs have been established to evaluate new compounds and regimens. Although control of AIDS will be a long and arduous journey, an important beginning has been made.