Combivir: The HIV Drug in Hasan's Shoe Box

Among the few belongings that Major Nidal Malik Hasan didn't give away, and left behind in his Casa del Norte apartment near Fort Hood, was his stash of prescription and over-the-counter medications. Stuffed into a shoe box and left in the laundry room, the collection included vitamins and an old bottle of an anti-HIV drug called Combivir.

Hasan's prescription was dated 2001. At that time, he would have been at the Uniformed Services University of Health Sciences in Bethesda, Md., where he was studying medicine tuition-free, a benefit of his enlistment in the Army. The prescription, as a photograph shows, appears to have been filled by Wilford Hall Medical Center at the U.S. Air Force Base in Lackland, Texas. (See pictures of Nidal Malik Hasan's life.)

Approved by the Food and Drug Administration in 1997, Combivir was the first pill to combine HIV drugs, and it contained the first-ever agent approved for the treatment of AIDS — zidovudine (better known as AZT) as well as lamivudine (3TC). Both drugs were part of the first class of medications used to fight HIV, and until recently, they formed the backbone of combination therapy against HIV. (See pictures of Nidal Malik Hasan's apartment.)

On its own, however, Combivir is not generally recommended as a first-line therapy against the disease — even combined, its two agents are considered too weak to keep the virus from developing resistance. The pairing was effective as a protective safety net, however, and in 1998, the Centers for Disease Control and Prevention recommended Combivir, either alone or together with a more powerful protease-inhibitor medication, for health care workers who were exposed to blood or fluid that might contain HIV. Some studies showed that coupling the drugs could reduce risk of infection in health care workers by as much as 79%.

While relatively safe, in recent years the drug's AZT portion has been linked to abnormal loss of fat deposits, particularly in the face and limbs. Other medications that patients only need to take once a day, as opposed to AZT's twice-daily dosing, have also made Combivir less popular in today's AIDS lexicon than it once was.

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