Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - Wednesday December 10, 2003
Maggie Fox, Health and Science Correspondent

The cocktail includes the oldest HIV drug, GlaxoSmithKline's AZT, also known as zidovudine; Glaxo's Epivir, known as lamivudine or 3TC; and Bristol Myers Squibb's efavirenz, sold under the brand name Sustiva.

The researchers said their government-funded studies, published in the New England Journal of Medicine, were aimed at helping doctors and patients navigate through the maze of 19 HIV drugs.

"These findings offer new insight into the most effective approach for treating previously untreated HIV-infected individuals," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a statement.

"Until now, it has been unclear which sequences of antiretroviral regimens provide the greatest benefit to patients previously untreated," said Dr. Gregory Robbins of Massachusetts General Hospital and Harvard Medical School, who led one of the studies.

"Findings from this and similar studies can help reduce some of the guesswork involved," he added.

Human immunodeficiency virus, which infects 40 million people around the world and 900,000 in the United States, is incurable and leads to AIDS.

But a cocktail of drugs called highly active antiretroviral therapy can suppress the virus and keep patients healthy for years.

DOCTORS CONFUSED

Eventually one combination stops working and the patients must switch to a new mix. Doctors have been confused about when to start patients on drugs and which cocktail is the most effective.

Pharmaceutical companies keep adding drugs to the arsenal.

There are now four classes of HIV drugs on the market, and mixing at least two classes usually works best. They include the protease inhibitors and the non-nucleoside RTIs.

Robbins and colleagues compared four three-drug combinations in 620 patients in the United States and Italy over two years.

They included Bristol's Videx, also called didanosine or ddI, and Zerit, also known as stavudine or d4T, plus either the NNRTI Sustiva, known generically as efavirenz, or the protease inhibitor nelfinavir, made by Pfizer-owned Agouron Pharmaceuticals under the brand name Viracept.

Two other groups began treatment with AZT, Epivir and either Zerit or Sustiva.

One combination seemed especially dangerous, they found.

"Subjects who initially received didanosine and stavudine had substantially more toxic effects than those who initially received zidovudine and lamivudine," the researchers wrote.

In a second study Dr. Robert Shafer of Stanford University in California and colleagues checked to see whether using four drugs would be better.

Their test of 360 patients found that after 28 months, the four-drug regimens worked no better.

031210
RE031215

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .