Four Drugs Not Better Than Three for HIV

In HIV-infected patients starting antiretroviral therapy, addition of abacavir to zidovudine, lamivudine, and efavirenz does not improve treatment results.

Standard initial therapy for HIV infection is two NRTIs plus either efavirenz or a PI. Might antiretroviral activity be better with four drugs than with three?

In the AIDS Clinical Trials Group Study A5095, a multicenter, randomized, double-blind trial, researchers compared AZT/3TC/abacavir (triple-NRTI), AZT/3TC plus efavirenz (standard 3-drug therapy), and AZT/3TC/abacavir plus efavirenz (4-drug therapy) in antiretroviral-naive adults with HIV infection. The triple-NRTI arm was discontinued early because of higher rates of virologic failure in this group than in the others. The analyses reported here were based on the 765 patients initially randomized to the remaining arms (median follow-up, 144 weeks).

The 3-drug and 4-drug regimens showed…

Reviewing Author

Rajesh T. Gandhi, MD

Four Drugs Not Better Than Three for HIV

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Reviewing Author