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

h the approval of new dosage formulations, this information could improve the management of patients in this country and in regions of the world where access to medical care and treatment compliance can be challenging," said AHRQ Director Carolyn M. Clancy, M.D. “These findings highlight the need for additional research that evaluates the extent to which improvements in markers of a disease, such a viral suppression, lead to improved clinical outcomes.”

The Centers for Disease Control and Prevention estimates that between 1 million and 1.2 million people in the United States are living with HIV, and at least 40,000 new infections occur each year. Worldwide, approximately 40 million individuals are infected with the virus.

Researchers, led by Roger Chou, M.D., at Oregon Health & Science University in Portland, completed an analysis of 26 trials, including 12 head-to-head trials comparing NNRTI-based regimens with protease inhibitor-based regimens. Fourteen other trials compared two-drug regimens with either NNRTI-based or protease inhibitor-based, triple-drug regimens. Among 3,337 patients analyzed in the head-to-head trials, NNRTI-based regimens were better than protease inhibitor-based regimens by 20 percent to 60 percent in their ability to achieve viral suppression.

Dramatic decreases in the rate of HIV-related illnesses and deaths have occurred since the introduction of HAART therapy in which three or more antiretroviral agents are used. However, until now, comparisons of head-to-head trials were not available to support selection of a protease inhibitor or an NNRTI as part of that combination therapy. Researchers concluded that earlier analyses may be unreliable because their results differed dramatically from the analysis of head-to-head trials, even after excluding patients who had previously received HIV therapy and those who had received older NNRTIs, such as delaviridine, that are now used infrequently because they are l
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