Treatment for HIV-positive individuals with persistent viral replication despite therapy with multiple regimens is effective and safe over two years when it omits nucleoside reverse transcriptase inhibitors (NRTIs), provided patients have three active alternative drugs available, according to research published in the Journal of Infectious Diseases.
The research updates previously published 48-week data.
Although NRTIs have been the backbone of ART since the mid 1990s, this class of anti-HIV drugs is associated with numerous side-effects.
Guidelines recommend that people living with HIV who experience the virological failure of their antiretroviral therapy (ART) should start a new regimen including two, preferably three, new drugs. Although NRTIs have been the backbone of ART since the mid 1990s, this class of anti-HIV drugs is associated with numerous side-effects.
The OPTIONS study was open to treatment-experienced people taking a protease inhibitor-based regimen and experiencing virological failure. The participants had virus that was sensitive to at least three antiretrovirals and were randomised to receive a new regimen that omitted or added NRTIs. Treatment was selected after a review of treatment history and resistance testing.
The 48-week results showed that the rate of virological suppression among the people randomised to omit NRTIs was non-inferior to that observed in those randomised to receive an NRTI-containing regimen. In the present paper, Dr Rajesh Gandhi of Massachusetts General Hospital and colleagues extended their analysis through to week 96.