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HIV
RNA Decline within the First 2 Weeks of Treatment Is Comparable
for Nevirapine, Efavirenz, or Both Drugs Combined and Does Not Predict
Long-term Virologic Efficacy
The initial rate of plasma
HIV-1 RNA (pVL) decline has been proposed as a marker
of early efficacy of antiretroviral therapy (ART) and a possible
predictor of late efficacy.
In this substudy of the 2NN
trial, researchers compared the rate of pVL decline in
patients starting ART with nevirapine/NVP
(Viramune), efavirenz/EFV
(Sustiva), or both drugs combined in addition to lamivudine/3TC (Epivir-HBV)
and stavudine/d4T
(Zerit).
Results
·
median
viral decay constant (VDc) (log10 copies per day), was similar for
NVP (0.30), EFV (0.31), and NVP + EFV (0.30).
·
Patients with a baseline pVL >100,000 copies/mL
were 8.7 times more likely to have a VDc >75th percentile.
High VDc was not associated with plasma drug concentration
or with a decreased risk of virologic failure at week 48 after the
start of therapy.
Conclusions
·
NVP,
EFV, or NVP + EFV in combination with 3TC and d4T show similar rates
of plasma viral load decline during the first 2 weeks of treatment.
·
The
viral decay constant with these regimens is not predictive of late
virologic efficacy.
International
Antiviral Therapy Evaluation Center, Department of Internal Medicine,
Academic Medical Center, University of Amsterdam, The Netherlands.
03/21/05
Reference
F van Leth and others (for the 2NN Study Group). Plasma HIV-1 RNA decline within the
first two weeks of treatment is comparable for nevirapine, efavirenz,
or both drugs combined and is not predictive of long-term virologic
efficacy: A 2NN substudy. Journal of Acquired Immune Deficiency
Syndromes 38(3):
296-300. March 1, 2005.
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