Drug companies are working on more that do the same thing, including some that work against resistant strains of the virus. Also in testing are medicines that exploit entirely different targets in the virus life cycle. Likely to be approved next are drugs that bar the virus from attaching itself to blood cells, the first step in infection. The virus makes about a dozen proteins, and all of them could potentially be blocked by medicines. Fears that the highly effective AIDS drugs would quickly lose their punch have not come true.
Most patients continue to do well, although long-term side effects are the biggest worry.
Side effects include an abnormal redistribution of body fat that leaves buffalo humps and skinny faces and extremities, along with a variety of metabolic complications, such as high blood sugar and cholesterol. Thinning bones are the latest anxiety. Eventually some run out of options. Nevertheless, they often stay healthy if they remain on treatment. The virus in their bodies is so weakened by its drug-resisting mutations that it does relatively little damage.