Comparison of 3-drug versus 4-drug and PI versus non-PI combinations as initial HAART: experience from 1998 to 2007.
Although established in controlled studies that there is no advantage to 4-drug highly active antiretroviral therapy (HAART) or regimens with or without protease inhibitors (PIs), we questioned this finding in a clinical setting (ie, no inclusion criteria). Ours is a single clinic retrospective study including all participants >18 years of age during their first year of HAART. A total of 190 participants were reviewed, with 168 (88%) attaining a viral load <400 copies/mL at the end of a year of HAART; 144 of 164 (88%) succeeded with 3 drugs and 24 of 26 (92%) with 4 drugs (P = .51). In all, 59 of 71 (83%) succeeded using a PI versus 109 of 119 (92%) without a PI (P = .08). Male gender and exposure time to HAART were significant variables for a successful outcome. Failures were due to side effects (50%), nonadherence (45%), and drug allergy (5%). Our results support current guidelines recommending 3-drug HAART.
Jhaveri
Malhar A
MA
University of Kentucky College of Public Health, Lexington, KY 40536, USA.
Browning
Steven R
SR
Bush
Heather
H
Thornton
Alice
A
Greenberg
Richard N
RN
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000480:Alkynes; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D000069446:Atazanavir Sulfate; D048588:Benzoxazines / Q000627:therapeutic use; D015331:Cohort Studies; D003521:Cyclopropanes; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000150:complications; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007629:Kentucky; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019829:Nevirapine / Q000627:therapeutic use; D009842:Oligopeptides / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D010078:Oxazines / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use; D012189:Retrospective Studies; D012737:Sex Factors; D019562:Viral Load; D055815:Young Adult; D015215:Zidovudine / Q000627:therapeutic use; D000099227:Abacavir
D000225:Adenine; D000480:Alkynes; D000069446:Atazanavir Sulfate; D048588:Benzoxazines; D003521:Cyclopropanes; D003841:Deoxycytidine; D004338:Drug Combinations; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D000069480:Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D019259:Lamivudine; D019829:Nevirapine; D009842:Oligopeptides; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D010078:Oxazines; D011480:Protease Inhibitors; D011725:Pyridines; D015215:Zidovudine; C418262:abacavir, lamivudine, and zidovudine drug combination; D000099227:Abacavir; C109078:lamivudine, zidovudine drug combination; C098320:efavirenz