Options explored for HIV patients unable to take efavirenz
Source: NIBSC / Science Photo Library
Efavirenz-containing antiretroviral regimens are recommended as first-line therapy for HIV infection. However, efavirenz is not suitable for certain patients, including women contemplating pregnancy and those with severe psychiatric conditions.
A randomised open-label clinical trial, published in the Annals of Internal Medicine (2014;161(7):461-471), evaluated alternatives to efavirenz in 1,809 treatment-naïve HIV-infected patients. Over two years, all three regimens — atazanavir/ritonavir, raltegravir and darunavir/ritonavir — showed equivalent, high rates of virologic control.
Tolerability differed among the treatments, with ritonavir-boosted atazanavir resulting in higher discontinuation rates than the other regimens, primarily because of hyperbilirubinaemia. “For combined virologic efficacy and tolerability, ritonavir-boosted darunavir was superior to ritonavir-boosted atazanavir, and raltegravir was superior to both protease inhibitors,” write Jeffrey Lennox, from Emory University, Georgia, and co-authors.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066855
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