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Existing HIV Guidelines Offer Best Options for New Cases

The two recommended regimens are the most effective

TUESDAY, Oct. 31 (HealthDay News) -- Existing guidelines for the treatment of newly HIV-infected adults do indeed recommend the most effective three-drug combination of antiretroviral therapy regimens, according to a meta-analysis published in the Oct. 24 issue of AIDS.

John A. Bartlett, M.D., of Duke University Medical Center in Durham, N.C., and colleagues analyzed 53 trials with 14,264 patients who were in 90 treatment arms. They looked at the relative effectiveness of three-drug combinations: two nucleoside reverse transcriptase inhibitors (NRTI) or nucleotide and NRTI plus one of four drugs -- a protease inhibitor, a non-nucleoside RTI (NNRTI), a third NRTI or a ritonavir-boosted protease inhibitor (BPI).

While 55 percent of patients overall had plasma HIV RNA levels of less than 50 copies/mL at 48 weeks, 64 percent of those receiving NNRTI and BPI therapy had RNA levels below 50 copies/mL, compared with 54 percent for the NRTI group and 43 percent for the protease inhibitor group. CD4 cell count increases were also much greater in the BPI group at more than 200 cells/μL compared with 179 or greater for protease inhibitor and 161 or greater for the NRTI groups.

Another trend noted in the study was that the percentage of patients with plasma HIV RNA levels below 50 copies/mL increased as the publication dates of the studies became later.

"The results of this expanded overview offer important new observations on the success of contemporary antiretroviral treatment regimens in trials studying antiretroviral therapy-naive populations," the authors conclude.

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