Do Fixed-Dose Antiretroviral Combinations Reduce the Risk for Resistance?

Some antiretrovirals are now available as generics, an option that can reduce HIV treatment costs. Although data on the benefits of branded fixed-dose combination (FDC) single-pill regimens over generic multiple-pill regimens have been mixed, one potential advantage of FDCs is that partial noncompliance is impossible, potentially decreasing the risk for drug resistance.

To study this issue, researchers (with partial industry support) reviewed data on patients from eight cohorts and four clinical trials who experienced virologic failure after initiating antiretroviral therapy (ART) with efavirenz, tenofovir, and either FTC or 3TC. They compared the rate of emergent drug-resistance mutations (DRMs) between patients receiving the FDC Atripla an…