- The Washington Times - Wednesday, December 10, 2003


A three-drug cocktail used by many HIV-infected people proved clearly superior to other combinations at treating new patients in the biggest head-to-head comparison of AIDS medications to date.

The combination works better and longer, is easier to take, and suppresses the virus more quickly, the international study found, confirming what many AIDS specialists had believed.

Among the study’s other, more surprising findings: Four drugs are not necessarily better than three.

The study also was the first to determine the best sequence for drug combinations — critical information because patients’ medication must be changed when the virus mutates and begins to resist the first drugs.

Preliminary findings from the research were announced at an AIDS conference in the summer and have changed the U.S. Department of Health and Human Services’ guidelines for initial HIV treatment.

With 20 HIV drugs on the market and hundreds of possible combinations, the latest findings could simplify decisions.

“It confirms what physicians have suspected for a long time,” said Jose M. Zuniga, president of the International Association of Physicians in AIDS Care. “It’s important to question and re-examine from time to time what become established standards of care on the off chance we’re wrong.”

The study involved patients at 58 hospitals and clinics in the United States and 23 in Italy. Researchers, led by doctors at Harvard and Stanford universities, tested several three- and four-drug combinations of six HIV medicines.

They found that the best combination for people getting their first HIV medication was efavirenz, lamivudine and zidovudine, better known as AZT. The second two drugs are taken in a combination pill under the brand name Combivir, and efavirenz is sold as Sustiva.

The combination is now among the U.S. government’s three preferred initial regimens, and, according to Mr. Zuniga, is the most-prescribed AIDS drug combination in the country.

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