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Current HIV treatment guidelines list several “preferred” options for initial antiretroviral therapy (ART), all involving two nucleoside reverse transcriptase inhibitors (NRTIs) plus a nonnucleoside reverse transcriptase inhibitor (NNRTI), a ritonavir-boosted protease inhibitor (PI), or an integrase inhibitor. Clinical trials comparing “preferred” once-daily ART regimens against each another or against “alternative” ART regimens are not widely available, and clinicians are often forced to make inferences from cross-study comparisons, an approach that is considered less than ideal.
To address this issue, AIDS Clinical Trials Group (ACTG) researchers randomized 1857 HIV-infected treatment-naive patients to begin ART with one of four once-daily…