Timing and Choice of First-Line Antiretroviral Therapy

Faculty:

Joel E. Gallant, MD, MPH José Gatell, MD W. David Hardy, MD

Learning Objectives

Upon completion of this activity, participants should be able to:

• Explain new findings from prospective and retrospective studies comparing different NRTI backbones in first-line antiretroviral therapy
• Discuss new data on the relative efficacy of various antiretroviral agents in first-line therapy
• Describe the role of immunologic response to HAART in patient outcomes and the implications for the benefit of early first-line treatment
• Cite new results on the safety and efficacy of different boosted PI regimens among racial subgroups

Topics covered include:

• ACTG 5202: Abacavir/Lamivudine vs Tenofovir/Emtricitabine in Treatment-Naive Patients With HIV-1 RNA ≥ 100,000 copies/mL
• Reanalysis of Abacavir Studies Using ACTG 5202 Endpoints
• HEAT Study: Abacavir/Lamivudine vs Tenofovir/Emtricitabine, Both With Lopinavir/Ritonavir, at 96 Weeks
• Efavirenz vs Lopinavir/Ritonavir in Treatment-Naive Patients With Very Low CD4+ Cell Counts
• Protocol 004: Efavirenz vs Raltegravir in Treatment-Naive Patients at 96 Weeks
• Rilpivirine, a Second-Generation NNRTI vs Efavirenz in Treatment-Naive Patients at 96 Weeks
• First-line Didanosine-EC, Emtricitabine, Atazanavir in Resource-Limited Settings
• 100-mg Film-Coated Tablet Formulation of Ritonavir Is Bioequivalent to the Soft-Gel Capsule in Single-Dose, Open-Label Crossover Study
• MONARK: Lopinavir/Ritonavir Monotherapy at 96 Weeks
• GS 903E: 7-Year Data, in a Small Cohort of Patients, on the Safety and Efficacy of Tenofovir/Emtricitabine Plus Efavirenz
• Substitution of Abacavir/Lamivudine for Thymidine Analogue NRTIs Maintains Virologic Efficacy and Offers Some Immunologic Advantages
• Analyses of Response to Antiretrovirals by Race
• Treatment of Acute HIV Infection With an NNRTI-Based Regimen Rather Than a Boosted PI-Based Regimen Effective in a Small Cohort
• IDX899 and RDEA06, 2 Novel NNRTIs, Show Considerable Promise in Phase IIa Trials
• Data From the MACS Cohort Indicate That Higher CD4+ Cell Counts Are Independently Associated With Lower Risk of AIDS and Death
• ATHENA Cohort: The Importance of Early Diagnosis