Triple-nucleoside analog antiretroviral therapy: is there still a role in clinical practice? A review.
The development and widespread clinical use of coformulated abacavir/lamivudine/zidovudine (ABC/3TC/ZDV) as Trizivir represented an important advance in the management of HIV-infected patients, especially those with adherence challenges. With a low pill burden, no food restrictions, limited drug-drug interactions, and a favorable resistance profile, ABC/3TC/ZDV remains an alternative option in the US Department of Health and Human Services Consensus Panel Guidelines as initial treatment in antiretroviral-naive patients. Recent data have shown ABC/3TC/ZDV to be less efficacious in suppressing and/or maintaining suppression of virologic replication compared with efavirenz-containing antiretroviral therapy. Although triple-nucleoside/nucleotide reverse transcriptase inhibitor (t-NRTI) combinations that do not contain a thymidine analog (ZDV or stavudine) have recently shown high virologic failure rates in clinical trials and clinical practice, t-NRTI regimens containing a thymidine analog have consistently been shown to be efficacious.
Kessler
Harold A
HA
Section of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA. hkessler@rush.edu
D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods* / Q000639:trends*; D002986:Clinical Trials as Topic / Q000639:trends; D015224:Dideoxynucleosides / Q000627:therapeutic use*; D004338:Drug Combinations; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011379:Prognosis; D016896:Treatment Outcome; D015215:Zidovudine / Q000627:therapeutic use*; D000099227:Abacavir
D044966:Anti-Retroviral Agents; D015224:Dideoxynucleosides; D004338:Drug Combinations; D019259:Lamivudine; D015215:Zidovudine; C418262:abacavir, lamivudine, and zidovudine drug combination; D000099227:Abacavir