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HIV integrase inhibitor effective for patients beginning antiretroviral treatment
Date:8/2/2009

A member of a new class of antiretroviral drugs is safe and effective for patients beginning treatment against HIV, according to researchers who have completed a two-year multisite phase III clinical trial comparing it with standard antiretroviral drugs.

The results are online and scheduled for publication in an upcoming issue of the Lancet.

Lead author of the Lancet article is Jeffrey Lennox, MD, professor of medicine (infectious diseases) at Emory University School of Medicine. Lennox is chief of Emory's HIV/AIDS clinical trials unit and vice-chair of medicine dealing with Grady Memorial Hospital.

"These results provide an additional potent, well tolerated treatment option for newly diagnosed patients with HIV infection," says Lennox.

Raltegravir, a HIV integrase inhibitor, is overall as effective as widely used efavirenz, a reverse transcriptase inhibitor, the researchers found. Raltegravir also had faster onset of action and fewer adverse side effects. In the clinical trial, both were combined with two other standard retroviral drugs, tenofovir and emtricitabine.

The trial included 566 patients from 67 medical centers on five continents. The "primary endpoint" of the trial was pushing viral levels below 50 copies per ml of blood by week 48. Of the raltegravir group, 86 percent reached that goal, compared with 82 percent of the efavirenz group.

Half the raltegravir group reached the endpoint by week four, compared with less than 20 percent for the efavirenz group. In addition, the raltegravir group encountered fewer side effects such as headache, dizziness and elevation in levels of cholesterol.

Raltegravir inhibits the HIV integrase enzyme, which inserts the viral genome into the host cell's DNA. It was the first integrase inhibitor to be approved by the FDA. Other types of antiretroviral drugs inhibit HIV's protease or reverse transcriptase enzymes.

Guidelines from the U.S.
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Contact: Sarah Goodwin
sgoodwi@emory.edu
404-727-3366
Emory University
Source:Eurekalert

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