Drugs Compared in HIV Treatment

Novel compound achieves viral suppression goals as well as efavirenz with fewer adverse events
By Jeff Muise
HealthDay Reporter

MONDAY, Aug. 3 (HealthDay News) -- A combination treatment for HIV infection including the novel HIV-1 integrase inhibitor raltegravir was non-inferior to the established combination treatment including efavirenz in an international multicenter clinical trial, according to a study published online Aug. 3 in The Lancet.

Jeffrey L. Lennox, M.D., of the Emory University School of Medicine in Atlanta, and colleagues randomly assigned patients infected with HIV-1 from 67 treatment centers to receive combination treatments of tenofovir and emtricitabine with either 400 mg of oral raltegravir twice daily or 600 mg of oral efavirenz once daily. The study end point was reaching a viral RNA concentration of less than 50 copies per mL by the forty-eighth week of treatment.

With treatment, the researchers found that 86.1 percent of the raltegravir group and 81.9 percent of the efavirenz group achieved the study end point, and patients on raltegravir reached viral suppression in a shorter time than the efavirenz group. There were also significantly fewer adverse events related to drugs in the raltegravir group (44.1 percent) than in the efavirenz group (77.0 percent).

"Raltegravir-based combination treatment had rapid and potent antiretroviral activity, which was non-inferior to that of efavirenz at week 48. Raltegravir is a well tolerated alternative to efavirenz as part of a combination regimen against HIV-1 in treatment-naive patients," the authors conclude.

Several of the study authors have been paid speakers, consultants or investigators for pharmaceutical companies or hold pharmaceutical company stock. The study was funded by Merck.

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