The Body Covers: The XIII International AIDS Conference
ARV Clinical Trials -- II
July 11, 2000
Once-a-day therapy for HIV infection (TuPpB1167)Another exploration for defining a combination that can be taken just once a day was shown here. This study took advantage of the availability of two medications that have already been shown to be successful and are approved by the U.S. Federal Drug Administration (FDA) to be taken just once a day: efavirenz (Sustiva) and ddI (Videx). Here the researchers added a third medication, 3TC (Epivir), which is usually taken twice a day, and did a study where it was used just once a day, taking both tablets at the same time. They enrolled 70 people, all of whom took this as their first antiviral combination. The average initial viral load was just over 100,000 -- a cut-off that has been shown in several studies to be important, as those with a viral load over this level have been less successful on a number of combinations. Their results show that about 70% overall achieved a viral load below 50 copies after one year -- but only three patients had viral rebound at the end of a year. Most of the reasons for a lack of success at one year was due to side effects and early drop-outs from the study. There was no difference in the success rate on this combination for those whose baseline viral load was either above or below 100,000 copies, consistent with all other studies of efavirenz and two nucleosides.
This study provides some additional options for those attempting to define a very simple combination. While 3TC is only approved for use as a twice-a-day medication, much research is going on to determine if it can be successful when taken just once a day. While more work will be needed to be sure that 3TC is equally successful when taken once a day, this study does provide some information that suggests this might some day be the standard way to use 3TC.
Nevirapine (NVP) shown to be equally effective at both high and low viral loads (TuPpB1168) and
With the increased use of non-nucleosides in combinations over the past few years, there has been a lot of research exploring the success rates of nevirapine (Viramune). Mainly, there are two concerns with the use of nevirapine:
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