TORONTO, Aug 13, 2006 (AFP) - Hopes that taking a combination of four antiretroviral drugs might provide a revolutionary new weapon against HIV are false, according to a study released at the world AIDS conference here.
Over the past 15 years, researchers first discovered that taking two anti-HIV drugs was more effective than taking one, and then learnt that taking three -- the famous "triple cocktail" -- was better than two.
Combination therapy quickly suppressed levels of HIV in the blood, boosted levels of CD4 immune cells, delayed the clinical progression to AIDS and improved a patient's chances of survival, they found.
That success, while still not a cure for HIV, bred hopes that using four drugs in a combination could be even more effective. By acting faster, it could usefully reduce the time lag that enables a virus to mutate and thwart the medication.
But a study presented Sunday at the 16th International AIDS Conference found no difference between four-drug and three-drug combinations.
Roy Gulick of Weill Medical College of New York's Cornell University, who led the research, recruited 765 patients who were newly diagnosed with the human immunodeficiency virus (HIV) but had not previously received treatment.
Half were given a standard triple therapy (AZT, epivir and efavirenz) and the other half followed a four-drug regimen, comprising the same treatments plus abacavir, commercialised as Ziagen.
Over the three years of the study, 26 percent of the patients on the three-drug regimen met with "virologic failure," meaning that they eventually had to switch to different drugs in order to continue suppress HIV.
Among the four-drug regimen, the failure rate was 25 percent.
"We found no significant differences," said the study. "(...) Adding abacavir as a fourth drug to the standard initial three-drug regimen did not change toxicity or adherence but provided no additional benefit."
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