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Comparison of 3-Drug Versus 4-Drug and PI Versus Non-PI Combinations as Initial HAART: Experience From 1998 to 2007

University of Kentucky College of Public Health, Lexington, Kentucky

Steven R. Browning, PhD

University of Kentucky College of Public Health, Lexington, Kentucky

Heather Bush, PhD

University of Kentucky College of Public Health, Lexington, Kentucky

Alice Thornton, MD

University of Kentucky School of Medicine, Lexington, Kentucky

Richard N. Greenberg, MD

University of Kentucky School of Medicine, Lexington, Kentucky, Rngree01{at}uky.edu, Lexington VA Medical Center, Lexington, Kentucky

Although established in controlled studies that there is no advantage to 4-drug highly active antiretroviral therapy (HAART) or regimens with or without protease inhibitors (PIs), we questioned this finding in a clinical setting (ie, no inclusion criteria). Ours is a single clinic retrospective study including all participants >18 years of age during their first year of HAART. A total of 190 participants were reviewed, with 168 (88%) attaining a viral load <400 copies/mL at the end of a year of HAART; 144 of 164 (88%) succeeded with 3 drugs and 24 of 26 (92%) with 4 drugs (P = .51). In all, 59 of 71 (83%) succeeded using a PI versus 109 of 119 (92%) without a PI (P = .08). Male gender and exposure time to HAART were significant variables for a successful outcome. Failures were due to side effects (50%), nonadherence (45%), and drug allergy (5%). Our results support current guidelines recommending 3-drug HAART.

Key Words: protease inhibitors • nucleoside reverse transcriptase inhibitors • treatment naive • HIV

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 5, 299-307 (2009)
DOI: 10.1177/1545109709345666


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