Fourth HIV drug offers no benefit
Patients starting treatment for HIV infection do not benefit from the addition of a fourth drug to their antiretroviral regimen, say US researchers.
The researchers conducted a randomised, double-blind, placebo-controlled
study to find out whether a four-drug regimen
(zidovudine/lamivudine/abacavir plus efavirenz) would have better antiretroviral
activity than a standard three-drug regimen
(zidovudine/lamivudine plus efavirenz). They found that addition of abacavir
did not lead to significantly different plasma HIV levels, or affect
time to virologic failure, CD4 cell count or resistance mutations at
virologic failure over three years.
“High rates of virologic suppression achieved in this study support
current guidelines that recommend two nucleosides plus efavirenz among
preferred
regimens for the initial treatment of HIV-1 infection. Adding abacavir
as a fourth drug to the standard initial three-drug regimen did not change
toxicity or adherence but provided no additional benefit,” the
researchers conclude (JAMA 2006;296:769). |
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