Clinical Management
Clinical ManagementBrown Medical School
Initial Treatment: Preferred & Alternative Regimens
November/December 2005
HIV 101: Initial Treatment: Preferred Regimens
| NNRTI-Based | # pills/day |
| Efavirenz* + (lamivudine [3TC] or emtricitabine [FTC]) + (zidovudine [AZT, ZDF] or tenofovir DF [TDF]) | 2-3 |
| PI-Based | # pills/day |
| Lopinavir/ritonavir (Kaletra®) + (lamivudine [3TC] or emtricitabine [FTC]) + (zidovudine [AZT, ZDF]) | 8-9 |
HIV 101: Initial Treatment: Alternative Regimens
| NNRTI-Based | # pills/day |
| Efavirenz* + (lamivudine [3TC] or emtricitabine [FTC]) + (abacavir [ABC] or didanosine [ddI] or stavudine [d4T]) | 2-4 |
| Nevirapine** + (lamivudine [3TC] or emtricitabine [FTC]) + (zidovudine [ZDV] or stavudine [d4T] or didanosine [ddI] or abacavir [ABC] or tenofovir [TDF]) | 3-6 |
| NRTI-Based | # pills/day |
| Abacavir [ABC] + lamivudine [3TC] + zidovudine [ZDV]^ | 2 |
| PI-Based | # pills/day |
| Atazanavir + (lamivudine [3TC] or emtricitabine [FTC]) + (zidovudine [ZDV] or stavudine [d4T] or abacavir [ABC] or didanosine [ddI]) or (tenofovir [TDF] + ritonavir [RTV] 100mg/d) | 3-6 |
| Lopinavir/ritonavir (Kaletra) + (lamivudine [3TC] or emtricitabine [FTC]) + (stavudine [d4T] or abacavir [ABC] or tenofovir [TDF] or didanosine [ddI]) | 7-10 |
| Fosamprenavir or fosamprenavir/ritonavir or indinavir/
ritonavir or nelfinavir or saquinavir (hard- or soft-gel capsule)/ritonavir + (lamivudine [3TC] or emtricitabine [FTC]) + (zidovudine [ZDV] or stavudine [d4T] or abacavir [ABC] or tenofovir [TDF] or didanosine [ddI]) | 5-15 |
* Avoid in pregnant women and women with high pregnancy potential.
** Because of higher rates of hepatotoxicity, nevirapine should not be initiated in women with pre-nevirapine CD4-T cell counts less than 250 cells/mm3 or men with CD4-T cell counts less than 400 cells/mm3, unless the benefit clearly outweighs the risk.
^ To be used only when a preferred or alternative NNRTI- or PI-based regimen cannot or should not be used as first-line theapy.
Tables adapted from DHHS. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. October 6, 2005. Last accessed November 16, 2005.
This article was provided by Brown Medical School, and is a part of the publication Infectious Diseases in Corrections Report.
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