But the euphoria was short-lived. As it turns out, the drugs weren't as successful outside of controlled clinical studies, largely because individuals in the real world don't always take the drugs as conscientiously as clinical trial participants. Many people can't adhere to the complicated regimens, which often amount to taking 15 to 20 pills a day on a precise schedule. Skipping a drug even one day can give the virus time to replicate, which can prompt a resistance to drugs, similar to the way bacteria can become resistant to antibiotics if not taken properly. New research also appears to confirm that hidden reservoirs of HIV can remain in people whose virus appeared completely suppressed.
Recent studies indicate that people can become infected with drug-resistant viruses.
Another group of patients having trouble managing the virus are those who started taking drug therapy before the advent of protease inhibitors. Without a third, more powerful agent, the virus developed resistance. Leading AIDS researchers say that one of the best ways of ensuring success in treatment is to work with your doctor to find a realistic and user-friendly drug cocktail that fits your lifestyle, needs and limitations. A total of 14 AIDS drugs have been approved by the U.S. Food and Drug Administration, and more are expected soon. The two most common approaches used are combining two nucleoside analog reverse transcriptase inhibitors, such as AZT and 3TC, with a protease inhibitor, like nelfinavir or indinavir, or with a nonnucleoside reverse transcriptase inhibitor, like efavirenz.