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Initial Treatment: Preferred & Alternative Regimens

November/December 2005


HIV 101: Initial Treatment: Preferred Regimens

NNRTI-Based# pills/day
Efavirenz*
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (zidovudine [AZT, ZDF] or tenofovir DF [TDF])
2-3

PI-Based# pills/day
Lopinavir/ritonavir (Kaletra®)
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (zidovudine [AZT, ZDF])
8-9


HIV 101: Initial Treatment: Alternative Regimens

NNRTI-Based# pills/day
Efavirenz*
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (abacavir [ABC] or didanosine [ddI] or stavudine [d4T])
2-4
Nevirapine**
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (zidovudine [ZDV] or stavudine [d4T] or didanosine [ddI] or abacavir [ABC] or tenofovir [TDF])
3-6

NRTI-Based# pills/day
Abacavir [ABC] + lamivudine [3TC] + zidovudine [ZDV]^2

PI-Based# pills/day
Atazanavir
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (zidovudine [ZDV] or stavudine [d4T] or abacavir [ABC] or didanosine [ddI]) or (tenofovir [TDF] + ritonavir [RTV] 100mg/d)
3-6
Lopinavir/ritonavir (Kaletra)
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (stavudine [d4T] or abacavir [ABC] or tenofovir [TDF] or didanosine [ddI])
7-10
Fosamprenavir or fosamprenavir/ritonavir or indinavir/ ritonavir or nelfinavir or saquinavir (hard- or soft-gel capsule)/ritonavir
    + (lamivudine [3TC] or emtricitabine [FTC])
    + (zidovudine [ZDV] or stavudine [d4T] or abacavir [ABC] or tenofovir [TDF] or didanosine [ddI])
5-15

* Avoid in pregnant women and women with high pregnancy potential.

** Because of higher rates of hepatotoxicity, nevirapine should not be initiated in women with pre-nevirapine CD4-T cell counts less than 250 cells/mm3 or men with CD4-T cell counts less than 400 cells/mm3, unless the benefit clearly outweighs the risk.

^ To be used only when a preferred or alternative NNRTI- or PI-based regimen cannot or should not be used as first-line theapy.

Tables adapted from DHHS. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. October 6, 2005. Last accessed November 16, 2005.




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