July 9, 2002
Many cohort studies have reported a high frequency of changes in HAART regimens over time (i.e., percent of patients who change their first regimen within the first 18 months). Gute and colleagues from Frankfurt evaluated 183 patients started on abacavir/zidovudine/lamivudine (ABC/AZT/3TC) as their first regimen for whom CD4 and RNA data was available. Sixty percent were still on their initial regimen after a median of 20 months (40 percent switched or stopped).
The initial median viral load for the cohort was 5.05 log and the CD4 count was 217. There were eight cases of abacavir hypersensitivity reaction (4 percent). AZT was switched to d4T in 17 patients due to intolerance. Overall, 29 patients (15 percent) stopped HAART completely. The authors conclude that this triple NRTI regimen is simple and well tolerated.
I would comment that the results are equivalent or superior compared to many published reports regarding the tolerability/durability of the initial regimen. The virologic criteria for success was not discussed (i.e., didn't use less than 50 copies/ml as the target), so that may have impacted the results.
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