Alternative multidrug regimen provides improved suppression of HIV-1 replication over triple therapy

Gerrit J. Weverling, Joep M.A. Lange*, Suzanne Jurriaans, Jan M. Prins, Vladimir V. Lukashov, Daan W. Notermans, Marijke Roos, Hanneke Schuitemaker, Richard M.W. Hoetelmans, Sven A. Danner, Jaap Goudsmit, Frank De Wolf

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To compare the viral suppression of two antiretroviral regimens using three drugs or five drugs. Design: Two open-label studies using a three-drug (zidovudine, lamivudine and ritonavir) and a five-drug regimen (zidovudine, lamivudine, abacavir, indinavir and nevirapine) in study-drug-naive patients, except for one in the five-drug study. Methods: Participants with ≤ 10,000 HIV-1 RNA copies/ml in plasma at baseline were compared by means of Kaplan-Meier curves for time to < 50 copies/ml, as well as linear regression analysis for the first phase of decline using log-transformed copy numbers. Results: The elimination rate constants For HIV-1 RNA in 15 participants of the three-drug study were compared with nine participants of the five-drug study. The level of < 50 copies/ml was reached earlier when using the five-drug than when using the three-drug regimen (P log rank = 0.0005): median time to reach this level was 4 weeks and 12 weeks, respectively. No differences were found in HIV-1 RNA elimination rate constants in the first 2 weeks after the initiation of therapy. When the viral load declines were calculated from day 2 onwards, adjusting for differences in pharmacological delay of the drugs used, again no differences in early viral load decline were found between the two regimens. Conclusion: With the five drugs used in this study, the median time to reach < 50 HIV-1 RNA copies/ml was 8 weeks shorter than with the three-drug regimen. This finding shows that suppression of viral load in HIV-infection by standard triple-drug therapy can be improved upon.

Original languageEnglish
Pages (from-to)F117-F122
Issue number11
Publication statusPublished - 30 Jul 1998

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