Nonnukes Lead to More Stable Therapy

An initial highly active antiretroviral regimen that contains a nonnucleoside reverse transcriptase inhibitor instead of a protease inhibitor may lead to more long-term treatment success and less need for later salvage therapy, according to a report in the October 15 edition of the journal AIDS. Canadian researchers studied long-term data from 291 HIVpositive people who started HAART with a protease inhibitor and 149 who began therapy with a nonnucleoside analog. Subjects on the nonnuke-based therapy stuck to their initial regimens for an average of 2.1 years, compared with 1.6 years for the protease inhibitor users. Nonnucleoside users were also less likely to experience virologic failure, to have been on three or more regimens, and to have been exposed to drugs from three anti-HIV drug classes. 'NNRTIs appear to be superior when used as initial HIV treatment with respect to tolerability, durability, and virologic responses, and thus may afford the best chance to avoid multiple salvage regimens,' the researchers conclude.