Most-Effective Drug Strategy for New HIV Patients

A new study has shown that how HIV drugs are combined and the order in which they are taken can make an important difference for patients who are just beginning treatment. The results were published in the December 11, 2003, issue of The New England Journal of Medicine.

The study involved researchers and participants from Italy and the United States, who compared the effectiveness of four three-drug sequencing strategies over a two-year period in 620 HIV-positive patients who had never before received antiretroviral therapy. The primary measure of a sequence's success was the amount of time before the second regimen failed. The greater the delay, the more successful was the sequence. Secondary measures included the amount of time before the first regimen failed, as well as the ability to suppress viral replication, development of resistance to the drugs, and drug toxicity. The results showed that when patients began treatment with a combination of the drugs zidovudine (AZT), lamivudine, and efavirenz, the drugs retained their effectiveness for a longer period of time.

"Until now, it has been unclear which sequences of antiretroviral regimens provide the greatest benefit to patients previously untreated,” said lead author Gregory K. Robbins, M.D., instructor in medicine at Harvard Medical School (Boston, MA, USA). "Findings from this and similar studies can help reduce some of the guesswork involved, enabling physicians to develop the most effective treatment plan for their HIV-positive patients.”




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