HIV regimens for treatment-naive patients compared
Treatment regimens
Patients received either efavirenz (Sustiva) 600mg plus tenofovir
disoproxil (Viread) 300mg and emtricitabine (Emtriva) 200mg once
daily, or efavirenz 600mg once daily plus a fixed dose of zidovudine
300mg and lamivudine 150mg twice daily (Combivir). |
After comparing two regimens for treatment-naive HIV patients, researchers suggest that a tenofovir-emtricitabine regimen is better than a zidovudine-lamivudine regimen in terms of lowering viral levels and increasing CD4 count
(New England Journal of Medicine 2006;354:251).
An open-label study involving 517 patients compared two regimens (see
Panel). The primary outcome measure was the proportion of patients with
HIV RNA levels of less than 400 copies/ml at week 48.
The researchers found that more patients in the tenofovir-emtricitabine
group reached the primary endpoint than in the zidovudine-lamivudine
group (84 per cent versus 73 per cent, 95 per cent confidence interval
for the difference 4–19; P=0.002). This difference not only indicates
that tenofovir-emtricitabine is not inferior to zidovudine-lamivudine
but shows a superior response, say the researchers.
They also observed that more patients in the tenofovir-emtricitabine
group maintained HIV RNA levels of less than 50 copies/ml (P=0.02). CD4
counts were also higher in this group and adverse events resulting in
drug discontinuation were lower.
“These findings have important implications for the choice of an
initial nucleoside-analogue backbone in the treatment of such patients,” the
researchers conclude. |
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