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Identifying treatment regimens that maximize antiviral potency and minimize long-term toxicity was an important focus of research presented at the 14th Retrovirus Conference. In ACTG 5142, treatment-naive patients were randomized to three class-sparing regimens: lopinavir/ritonavir + 2 NRTIs, efavirenz + 2 NRTIs, or lopinavir/r + efavirenz [Abstract 38]. After 96 weeks, rates of lipoatrophy (defined as ≥20% limb-fat loss by dual x-ray absorptiometry scans) were lowest among patients receiving lopinavir/r + efavirenz (9%). Within the nucleoside arms, lipoatrophy was significantly less common with lopinavir/r than with efavirenz (17% vs. 32%). Rates did vary, however, by nucleoside choice and were substantially higher for d4T and AZT than for…