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Abacavir and tenofovir have been compared in several randomized trials, including studies in treatment-naive patients (ACTG 5202 and HEAT) and switch studies (RAVE and STEAL). The latest switch trial (BICOMBO) involved 333 patients in Spain who had achieved virologic suppression on standard triple-drug regimens containing 3TC and were then randomized to switch their NRTI backbone to a fixed-dose formulation of either abacavir/3TC or tenofovir/FTC. HLA-B*5701 testing was not used. The trial was partially supported by the makers of the two coformulations.
By week 48, treatment failure occurred in 19% of abacavir/3TC recipients and in 13% of tenofovir/FTC recipients (P=0.06). Only four cases of virologic failure occurred in the study, and all w…