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The triple-nucleoside regimen AZT/3TC/abacavir (Trizivir) was once widely used because of its low pill burden and the absence of drug–drug interactions. However, enthusiasm waned when this combination was found to have lower virologic efficacy than standard treatments containing protease inhibitors or nonnucleoside reverse transcriptase inhibitors. Could a regimen consisting of four nucleoside reverse transcriptase inhibitors (NRTIs) provide better results?
To answer this question, investigators conducted a randomized clinical trial (Altair) comparing three regimens in treatment-naive, HLA-B*5701–negative, HIV-infected patients:
Tenofovir/FTC + efavirenz
Tenofovir/FTC + ritonavir-boosted atazanavir
Tenofovir/FTC + AZT + abacavir
The primary endp…