First-Line Therapy for HIV-Infected Patients

Virologic suppression is more likely with an efavirenz-based regimen than with a lopinavir/ritonavir-based one.

First-line therapy for HIV infection usually consists of two nucleoside reverse-transcriptase inhibitors (NRTIs) plus either the nonnucleoside reverse-transcriptase inhibitor (NNRTI) efavirenz or a ritonavir-boosted protease inhibitor (PI) such as lopinavir/ritonavir. Which of these two initial regimens is better? Also, NRTIs have been associated with toxicities such as lipodystrophy. Are regimens that do not include NRTIs as effective as ones that do? To answer these important questions, investigators randomized 757 HIV-infected, treatment-naive patients to receive one of three regimens: efavirenz plus two NRTIs (EFV group), lopinavir/ritonavir plus two NRTIs (LPV group), or lopinavir/ritonavir plus efavirenz (NRTI-sparing group).

The rate …

Reviewing Author

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

Rajesh T. Gandhi, MD

Disclosures

Grant/Research SupportNIH

Editorial BoardsUpToDate; ID Images (idimages.org); Infectious Diseases Society of America COVID-19 Treatment Guidelines; International Antiviral Society–USA (Guidelines Committee)

Leadership Positions in Professional SocietiesHIV Medicine Association; Infectious Diseases Society of America (Board of Directors)

First-Line Therapy for HIV-Infected Patients

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Reviewing Author