Study Identifies Viread And Emtriva As The Preferred Initial Treatment For HIV Patients
A recent study finds Viread (tenofovir) and Emtriva (emtricitabine) are more effective nucleoside reverse transcriptase inhibitors (NRTIs) than Ziagen (abacavir) and Epivir (lamivudine) as an initial combination therapy for HIV. The results were published in the New England Journal of Medicine.
A typical initial antiretroviral therapy regimen for HIV-positive patients who have not received therapy consists of two types of drugs: two NRTIs together with either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor. Until now, it was unclear which two NRTIs are the most effective and safe.
This Phase 3 trial, known as study A5202, compared the efficacy and safety of two NRTI combinations, Viread and Emtriva versus Ziagen and Epivir, in previously untreated patients. These drugs were chosen because they have few side effects, are easy to take, and are potent anti-HIV agents.
Nearly 2000 patients participated in the trial. The patients were divided into four groups who received Viread and Emtriva or Ziagen and Epivir along with either Norvir (ritonavir)-boosted Reyataz (atazanavir), a protease inhibitor, or Sustiva (efavirenz), an NNRTI.
Among the 797 patients who had high viral loads at the start of the study, changes in the number of CD4 cells, a type of white blood cell that helps the body battle infection, was not significantly different between the two treatment groups.
However, 14 percent of patients in the Ziagen and Epivir group were unable to maintain viral suppression, compared to only 7 percent of the Viread and Emtriva group. Patients receiving Viread and Emtriva were also able to maintain viral suppression longer.
Results also showed that the combination of Viread and Emtriva was safer, with 20 percent experiencing serious side effects compared to 33 percent of those taking Ziagen and Epivir.
These results will strengthen recommendations by the United States Department of Health and Human Services that list Viread and Emtriva as the preferred NRTI combination for HIV-positive individuals starting antiretroviral therapy for the first time.
The AIDS Clinical Trials Group conducted this study with funding from the National Institute of Allergy and Infectious Diseases, a branch of the National Institutes of Health, with additional support from the General Clinical Research Center.
For more information, please read about the study on the U.S. Clinical Trials Web site or in the New England Journal of Medicine (abstract). Treatment guidelines can be found on the Department of Health and Human Services Web site.
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