- The Washington Times - Monday, August 14, 2006

CHICAGO (AP) — A four-drug cocktail isn’t any better for treating newly diagnosed HIV infection than the standard three-drug regimen, according to a study that tracked 765 patients for three years.

The finding is welcome news to patient advocates, despite the lack of a step forward in treatment. Adding a fourth drug would have raised costs in an already overburdened system in which some states report waiting lists of uninsured patients who need help paying for their HIV drugs.

The annual cost per person for antiretroviral drug therapy in 2001 was about $11,000 a year, according to a previous study.

Murray Penner of the National Alliance of State and Territorial AIDS Directors estimated that increasing the number of drugs in already complex regimens could cost health systems millions more dollars.

“Keeping treatment regimens as simple as possible is also good news for people living with HIV/AIDS as adherence (taking drugs as prescribed) is better with easier and smaller regimens,” Mr. Penner said.

Adding a drug to the cocktail also could increase side effects and the potential for dangerous drug interactions, said Jim Pickett of the AIDS Foundation of Chicago.

The new study clears up a lingering question posed by the conflicting results of prior studies. Some smaller studies had found a quicker effect at beating back the virus when more drugs were added to the cocktail, while others found no added benefit.

“Triple drug therapy has been the standard approach to treatment of HIV infection for a decade or so, but there’s always been a question about whether we could do better with more drugs,” said study co-author Dr. Dan Kuritzkes of Harvard Medical School’s Brigham and Women’s Hospital.

“This reaffirms the potency of the current standard of care,” Dr. Kuritzkes said.

Researchers made the two drug cocktails equally easy for patients to take, delivering both in five pills taken daily. Patients and their doctors didn’t know which cocktail they were getting.

The study will appear in Wednesday’s Journal of the American Medical Association and was released yesterday to coincide with the opening of the 16th International AIDS Conference in Toronto.

Researchers found that the four-drug cocktail, which added the HIV drug abacavir, did not further reduce the amount of virus in patients’ blood. Compared with standard therapy, it also didn’t increase levels of CD4 cells that fight infection.

“Over the entire course of the study, at no point did there seem to be an advantage of the four-drug regimen,” Dr. Kuritzkes said.

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