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A More Convenient HIV Treatment Is as Effective as More Complex Regimens

Regimens to treat HIV infection that are based on a non-nucleoside reverse transcriptase inhibitor (NNRTI) are at least as effective as treatment with a protease inhibitor// but require patients to take fewer pills each day, according to a new study funded in part by HHS’ Agency for Healthcare Research and Quality.

The study, published in the October 28 online issue of the Lancet, found that disease progression was similar for both regimens, but NNRTI-based treatment appeared more effective at decreasing the amount of virus in the blood. The number of patients who stopped treatment because of adverse events was similar for both medications.

The new study is the first to review all published research that directly compares the two classes of antiretroviral drugs used in highly active antiretroviral therapy (HAART). NNRTI-based regimens were found to be up to 60 percent more likely to suppress the amount of virus in patients’ blood than protease inhibitor-based regimens. The percentage of patients who died or experienced disease progression were similar between the two treatments, and the number of patients who stopped taking the medications because of side effects or adverse events was also similar.

While some protease inhibitors require four doses each day, one NNRTI, efavirenz, can be taken in one daily dose. This convenience could increase the likelihood that patients will adhere to their HIV regimens.

Publication of the study follows the July 12 approval by the Food and Drug Administration of the first once-a-day medication to treat HIV. The drug contains emtricitabine and tenofovir, two nucleoside reverse transcriptase inhibitors, plus efavirenz. The components of the drug were previously available, but it is anticipated that the new combined formulation will simplify treatment and improve compliance.

"A simpler regimen offers the potential of improved adherence and better patient outcomes. Combined wit
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