Discounting Dual Therapy

Is it possible for treatment-naive HIVers to begin antiretroviral therapy with only two boosted protease inhibitors and no other anti-HIV medications? That's precisely what researchers in France recently aimed to discover in their study of 61 HIVers who began therapy with either Norvir-boosted Lexiva plus Reyataz or Norvir-boosted Invirase plus Reyataz. The results, unfortunately, were not as robust as the researchers had hoped. Although many of the study participants with viral loads above 50,000 did reduce HIV levels to below 50 copies after 16 weeks of treatment (40% of those taking Lexiva/Reyataz and 42% of those taking Invirase/Reyataz), the percentages were far below that seen after 16 weeks with multiclass antiretroviral combinations. "[Norvir]-boosted dual protease inhibitor regimens targeting only one step of viral replication were insufficient to rapidly suppress plasma HIV RNA ' in antiretroviral-naive patients with a high viral load at baseline," the researchers conclude in the Journal of Antimicrobial Chemotherapy.