Efavirenz-based initial therapies associated with better outcomes in HIV-infec...(Health Organization guidelines recommend...)

Date:10/14/2008

Health Organization guidelines recommend the use of a non-nucleoside reverse transcriptase inhibitor such as nevirapine or efavirenz in resource limited settings. Nearly 67 percent of countries in sub-Saharan Africa recommend nevirapine-based regimens for first line therapy because it is available at a lower cost and in a variety of generic fixed-dose combination regimens. In contrast, the U.S. Department of Health and Human Services and the International AIDS Society-USA both recommend the use of efavirenz because it has a more favorable toxicity profile and greater efficacy.

"Given the rapid roll-out of antiretroviral programs in Africa and the frequent use of first-line nevirapine-based HAART in such programs the assumption that efavirenz and nevirapine are equally effective needs to be reassessed," says Nachega, who is also professor and director of the Centre for Infectious Diseases at Stellenbosch University in South Africa. "Based on our results, there is a critical need for a large randomized clinical trial to definitively compare the outcomes of efavirenz and nevirapine and for acceleration of efforts to develop lower cost formulations of efavirenz, including generic, fixed-dose combinations in Africa."

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Contact: Tim Parsons tmparson@jhsph.edu 410-955-7619 Johns Hopkins University Bloomberg School of Public Health Source:Eurekalert

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