A quadruple-nucleoside intensification strategy was as safe and effective as a two-class intensification strategy, but questions remain about durability and long-term consequences.
AZT/3TC/abacavir is an attractive initial regimen for HIV treatment because of its simplicity, class-sparing properties, and relative lack of drug interactions. However, concerns exist about the durability of this regimen, and we know little about optimal intensification strategies.
When the AZT/3TC/abacavir arm of ACTG 5095 was discontinued because of relatively high virologic failure rates (ACC Jun 1 2004), investigators took the opportunity to conduct a roll-over study comparing two intensification strategies (two-class vs. quadruple-nucleoside). A total of 170 patients taking AZT/3TC/abacavir were randomized to add either efavirenz or tenofovir to their regimens. All patients had viral loads <200 copies/mL within 8 weeks before intensifi…