title: Once-daily quadruple-drug therapy with adefovir dipivoxil, Lamivudine, Didanosine, and efavirenz in treatment-naive human immunodeficiency virus type 1-infected patients.
abstract: A 48-week open-label study of 11 antiretroviral-naive, human immunodeficiency virus type 1 (HIV-1)-infected adults evaluated once-daily treatment with adefovir dipivoxil, lamivudine, didanosine, and efavirenz. At baseline, the median plasma HIV-1 RNA level was 4.99 log(10) copies/mL, and the median CD4 cell count was 471 cells/mm(3). At 24 and 48 weeks after initiation of treatment, median HIV-1 RNA levels decreased from baseline by 4.77 and 4.99 log(10) copies/mL, respectively, and median CD4 cell counts increased by 135 and 177 cells/mm(3), respectively. The regimen was generally well tolerated. No patients withdrew from the study because of adverse events. However, 7 patients developed adefovir-related nephrotoxicity after >/=20 weeks of treatment; this resolved without sequelae after adefovir was discontinued. Overall adherence was 85%. Once-daily quadruple-drug therapy with adefovir, lamivudine, didanosine, and efavirenz provides pronounced and durable suppression of HIV-1 RNA and elevation of CD4 cell counts over the course of 48 weeks, with generally good tolerability and adherence.
authors.affiliation: Roger Williams Medical Center, Providence, Rhode Island 02908, USA. Gail_Skowron@brown.edu
authors.forename: Gail
authors.initials: G
authors.lastname: Skowron
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kuritzkes
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Thompson
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Squires
authors.forename: S Diane
authors.initials: SD
authors.lastname: Goodwin
authors.forename: Betsy A
authors.initials: BA
authors.lastname: Dusak
authors.forename: Jerry M
authors.initials: JM
authors.lastname: Tolson
authors.forename: Michael
authors.initials: M
authors.lastname: Stevens
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Yuen
authors.forename: James F
authors.initials: JF
authors.lastname: Rooney
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000328:Adult; D000480:Alkynes; D048588:Benzoxazines; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D016049:Didanosine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D063065:Organophosphonates; D010078:Oxazines / Q000008:administration & dosage / Q000627:therapeutic use*; D020551:Pulse Therapy, Drug; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D063065:Organophosphonates; D010078:Oxazines; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000225:Adenine; C098320:efavirenz; D016049:Didanosine; C106812:adefovir dipivoxil