Nevirapine or lamivudine plus stavudine and indinavir: examples of 2-class versus 3-class regimens for the treatment of human immunodeficiency virus type 1.
We compared use of a 3-class regimen (nevirapine [Nvp], stavudine [d4T], and indinavir [Idv; 1000 mg 3 times daily]) with use of a 2-class regimen (lamivudine [3TC], d4T, and Idv [800 mg 3 times daily]) for 145 patients infected with human immunodeficiency virus type 1 (HIV-1). At week 72, the plasma HIV-1 RNA level was undetectable in 52% of Nvp recipients versus 79% of 3TC recipients (P<.001). Idv trough levels were 81 ng/mL in the Nvp group and 99 ng/mL in the 3TC group (P=.012). In the Nvp group, 42.5% of patients discontinued the study regimen; in the 3TC group, 22.5% of patients discontinued therapy (P=.013). The rate of resistance to nonnucleoside analogue reverse-transcriptase inhibitors among patients in the Nvp group with virological failure was not different from the rate of resistance to 3TC among patients in the 3TC group with virological failure. These results do not support the use of a 3-class regimen that includes Nvp for patients with no or limited exposure to nucleoside analogues.
Launay
Odile
O
Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, Paris, France. odile.launay@avc.ap-hop-paris.fr
Gérard
Laurence
L
Morand-Joubert
Laurence
L
Flandre
Philippe
P
Guiramand-Hugon
Sonia
S
Joly
Véronique
V
Peytavin
Gilles
G
Certain
Agnès
A
Lévy
Claude
C
Rivet
Stéphane
S
Jacomet
Christine
C
Aboulker
Jean-Pierre
JP
Yéni
Patrick
P
D000328:Adult; D019380:Anti-HIV Agents / Q000097:blood / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D019469:Indinavir / Q000097:blood / Q000627:therapeutic use; D019259:Lamivudine / Q000097:blood / Q000627:therapeutic use; D008297:Male; D019829:Nevirapine / Q000097:blood / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D018119:Stavudine / Q000097:blood / Q000627:therapeutic use
D019380:Anti-HIV Agents; D019259:Lamivudine; D019469:Indinavir; D019829:Nevirapine; D018119:Stavudine