Predictors of Response to Second-Line Therapy — Do the NRTIs Matter?

The optimal management of patients who experience virologic failure on first-line nonnucleoside reverse-transcriptase inhibitor (NNRTI)-containing antiretroviral regimens is uncertain. Guidelines recommend use of at least two fully active drugs in second-line regimens; in practice, such regimens usually consist of a boosted protease inhibitor (PI) and one or more nucleoside reverse-transcriptase inhibitors (NRTIs). However, the potency of boosted PIs may render inclusion of a fully active NRTI backbone unnecessary.

To evaluate this hypothesis, researchers retrospectively analyzed the effect of adding — or not adding — new NRTIs to a boosted PI for patients in the U.K. Collaborative HIV Cohort who experienced treatment failure on NNRTI-contai…