Combination, order of anti-HIV drugs make a difference in first-time recipients

How anti-HIV drugs are combined and the order in which they are given are important factors to consider when designing treatment strategies for patients new to antiretroviral therapy, says a new study funded by the National Institute of Allergy and Infectious Diseases (NIAID), one of the National Institutes of Health. When HIV-infected individuals begin treatment with a combination of the drugs zidovudine, better known as AZT, lamivudine and efavirenz, the drugs retain their effectiveness for a longer period of time than when individuals begin treatment with one of several other three-drug regimens.

The study, which involved researchers and participants from the United States and Italy, was one of the largest and most complex of its kind to help in determining the optimal drug treatment strategy for first-time recipients of antiretroviral drugs. The findings are reported in two papers published in the Dec. 11 issue of The New England Journal of Medicine, and have been incorporated into the U.S. Department of Health and Human Services HIV/AIDS Treatment Guidelines.

"These findings offer new insight into the most effective approach for treating previously untreated HIV-infected individuals," said Anthony S. Fauci, M.D., director of the NIAID. "Through well-conceived, collaborative clinical studies such as this one, researchers are learning how to use the many anti-HIV drugs now on the market to provide the maximum benefit for the longest period of time."

Highly active antiretroviral therapy (HAART) employs combinations of anti-HIV drugs to help suppress the virus in people with HIV/AIDS. The goal of HAART is to combine three or more drugs from one or more different classes of anti-HIV drugs to suppress HIV replication and prevent progression to AIDS and death. Two key classes include those that prevent the virus from copying itself, called reverse transcriptase (RT) inhibitors, and those that prevent the virus from becoming infectious, called

Contact: Jennifer Wenger
NIH/National Institute of Allergy and Infectious Diseases

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