Antiviral effect of double and triple drug combinations amongst HIV-infected adults: lessons from the implementation of viral load-driven antiretroviral therapy.
OBJECTIVE
To study the antiviral effect and predictors of response to two- and three-drug regimens amongst antiretroviral-naive individuals using an intent-to-treat analysis.


METHODS
Suppression of plasma viral load to < 500 copies/ml.


METHODS
A total of 420 (264 double drug, 156 triple drug) individuals in a province-wide treatment programme were studied.


RESULTS
A decrease in plasma viral load to < 500 copies/ml was documented in 197 (47%) subjects. This was independently associated with a lower baseline plasma viral load (odds ratio, 3.67; 95% confidence interval, 2.13-6.30) and initiation onto a three-drug regimen (odds ratio, 3.86; 95% confidence interval, 2.24-6.66). Median plasma viral load failed to reach < 500 copies/ml and in fact rebounded in the two-drug group. In contrast, 91 (58%) subjects receiving three drugs reached < 500 copies/ml during the study period.


CONCLUSIONS
These results support the use of powerful triple drug regimens as initial therapy in HIV-infected individuals.
Hogg
R S
RS
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, University of British Columbia, Vancouver, Canada. bobhogg@hivnet.ubc.ca
Rhone
S A
SA
Yip
B
B
Sherlock
C
C
Conway
B
B
Schechter
M T
MT
O'Shaughnessy
M V
MV
Montaner
J S
JS
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D016049:Didanosine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D015999:Multivariate Analysis; D018119:Stavudine / Q000008:administration & dosage*; D019562:Viral Load; D016047:Zalcitabine / Q000008:administration & dosage*; D015215:Zidovudine / Q000008:administration & dosage*
D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine; D016047:Zalcitabine; D018119:Stavudine; D016049:Didanosine