DOT — Not Worth the Effort in Treatment-Naive HIV Patients

An open-label, randomized trial failed to show a lasting advantage for modified directly observed antiretroviral therapy over self-administered therapy.

Directly observed therapy (DOT) is the standard of care for tuberculosis (TB). Preliminary studies, mostly in small cohorts and in supervised settings such as prisons, have also shown promise for DOT in managing HIV infection.

In an open-label trial conducted at 23 ACTG sites in the U.S. and 1 site in South Africa, 243 treatment-naive HIV-infected patients (79% men; 35% Latino; 30% black; 33% white) were randomized to receive modified DOT with once-daily lopinavir/ritonavir or self-administered therapy with either once- or twice-daily lopinavir/r. All regimens included FTC and either extended-release d4T or tenofovir. In the DOT group, lopinavir/r treatment was supervised on weekdays and unsupervised on weekends; this group switched to self-…

Reviewing Author

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

Helmut Albrecht, MD

Disclosures

Grant / Research supportHealth Resources and Services Administration; Centers for Disease Control and Prevention

Leadership positions in professional societiesColumbia Medical Society; South Carolina Infectious Diseases Society

DOT — Not Worth the Effort in Treatment-Naive HIV Patients

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Reviewing Author