Potent anti-HIV regimens containing a protease inhibitor (PI) and two nucleoside reverse transcriptase inhibitors (NRTIs) achieve viral suppression in a high proportion of people with HIV who take them. But, said Spencer Cox of TAG, co-moderator of Session B17 on Clinical Trials, "There are serious drawbacks and limitations with these regimens."

Shlomo Staszewski, of the Goethe University, Frankfurt, reported early results from one of the first trials to compare a three-drug regimen containing a non-nucleoside RTI (NNRTI, efavirenz, DMP-266) plus two NRTIs (ZDV/3TC) against a PI triple combination of indinavir plus ZDV plus 3TC. He called the PI triple-drug arm "one of today's most active standard-of-care regimens." At 24 weeks, on-treatment analysis showed that the efavirenz triple therapy arm had dropped viral load under 400 copies/ml in 94.5% of subjects, compared to 88.6% with the PI triple regimen. Using the most stringent analysis, in which non-completers count as failures, the efavirenz triple therapy arm brought viral loads below 400 in significantly more patients than the PI triple, 75% vs. 56%.

this story can also be found in The Bridge, the onsite print newspaper

"We need longer-follow-up," Staszewski said. Data will be analysed at 48 and 72 weeks. Also, the trial will expand to 1,200 patients.

Co-moderator Martin Hirsch, of Harvard University, told The Bridge that ACTG384 will begin soon in the US comparing two NRTIs with efavirenz to two NRTIs plus nelfinavir.

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