Seeking the Best HIV Drugs

A head-to-head comparison of three now-dated regimens endorses an efavirenz-based combination, but the race is very close.

With dozens of three-drug permutations available for initial HIV treatment, clinicians (and pharmaceutical companies) are ever eager for a clear statement about which is “best.” Making that determination is not an easy task, as a large randomized NIH study makes clear.

More than 700 untreated HIV-positive patients with fairly late-stage disease (more than half had CD4 cell counts <200/mm³) received one of three open-label treatments:

(L/R), a protease inhibitor–based regimen (lopinavir/ritonavir with 2 nucleoside drugs);
(E), a non-nucleotide reverse transcriptase–based regimen (efavirenz with 2 nucleoside drugs); or
(L/R/E), a nucleoside-sparing regimen (lopinavir/ritonavir with efavirenz).

After 2 years of treatment, patients in the E group we…

Reviewing Author

Abigail Zuger, MD

Disclosures

Nothing to disclose

Abigail Zuger, MD

Disclosures

Nothing to disclose

Seeking the Best HIV Drugs

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Reviewing Author