Ebola successfully treated with HIV drug

A 15 patient trial?

That is worthless

Excellent news, and not too suprising.

However, I disagree with this:

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He also knows American researchers will say only a real study can prove effectiveness. That would involve taking a much larger patient population and giving half of them lamivudine and the other half a placebo.

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There's no real need to use the typical research protocol in this situation. We know what Ebola does if untreated, and if the drug produces dramatically different results then we know it works even if we don't know why.

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this late in the outbreak of a relatively mild Ebola to begin with.

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I thought that this outbreak had killed more people than any other outbreak?

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I thought that this outbreak had killed more people than any other outbreak?

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Because it is "mild."


It is a known epidemiological fact that highly lethal outbreaks burn out rapidly because they kill the host before they get ample chance to spread.

And that when dealing with exceedingly lethal outbreaks, milder strains tend to get selected for as you progress generations past Patient Zero.

Ebola Zaire outbreaks typically clock in at a mortality of 80-90%


This outbreak of Zaire subtype is clocked in at between 50-70%

Thank you for the lesson. Makes perfect sense but I never thought of that.

Equivalent of throwing some dirt on it.

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if the drug produces dramatically different results then we know it works even if we don't know why.

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The drug in question is an nRTI. If it does show efficacy, we know exactly why. It gets picked up by the viral DNA or RNA polymerase (I forget which nucleotide/side analog this is. And I think Ebola is an ssRNA, but I'm not positive), and incorporated into the replication of more viral particles, where it halts the replication cycle. Nothing about the drug is engineered to work specifically against HIV.

Actually, the class as a whole of nRTIs were originally created as cancer drugs to kill rapidly proliferating cells. It was later tried/found to have action vs HIV. It's basically really good at stopping replication. They're also typically picked up and incorporated into mitochondrial DNA, leading to most of the toxic side effects associated with the drug.


And, for fun, they're very effective against HIV for the most part. The HIV virus is short and rapidly mutates, though. Over 24h, every single point mutation that could occur has occurred. 1/2 the double recombinants possible have occurred. Some of these combos are predictably resistant to drugs, as above, and they then take over as the predominant strain of HIV in the body, leaving the drugs much less effective. Why am I bringing this up? As Ebola viruses aren't retroviruses, they're likely to be much lower on their mutation rates, leading to higher efficacy of these drugs, should we find that these kinds of drugs are effective.


Lastly, calling nRTIs "anti-HIV" drugs is technically correct, but they're not really specific for HIV (see above). You likely won't see other classes of HIV meds (nnRTIs, PIs, fusion inhibitors,...) in treatment of anything non-HIV because they're engineered specifically for parts of the HIV virus that aren't expected to exist in other viruses (I say "expected" because the polymerase and professes are believed to be unique to HIV, but it would be premature to say that they are, as most viruses aren't nearly as well studied as HIV).

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They will end a trial if drug is shown to be overwhelmingly affective vs the alternative treatment.

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The trial isn't scrapped if one drug is more effective, it's that there's a pronounced, significant mortality benefit with drug v placebo. As it pertains to Ebola, of course, they're one and the same. If you're speaking about trials in general, though, a mortality difference must be present, unless I'm mistaken.


ETA: my choice of the word "placebo" is poor and should read "current standard of care" because it would be unethical to give a placebo to a group in a trial where a high mortality is involved and a standard of care is established, or a known lack of care, as with Ebola, is highly fatal.

Its a touchy subject.




I feel the exact opposite.


Situations like this are the only times that we will ever being able to grabble with Ebola. You may not need to dot the i's and cross the t's on the work, but some consideration to following protocol need to be made.


That way we can turn Ebola into something that is potentially treatable and practically no different than the host of other deadly tropical diseases that subside to Western medicine.

Think his protocol should be adopted further. His reasoning is sound on his decision to use this drug. Saving lives is his focus, not lawyers, which is how it should be.