Skip to main content

Initial Antiretroviral Regimens

  • Reference work entry
  • First Online:
  • 7 Accesses

Definition

The first antiretroviral drug regimen used to treat a previously treatment-naïve HIV-infected patient.

Introduction

Although there are many possible choices for initial antiretroviral therapy (ART) in an HIV-infected patient, only a small subset of the potential options are now recommended in treatment guidelines used in most resource-rich settings. Recommendations are based on a combination of efficacy, safety, tolerability, convenience, and in some cases cost. This review will focus primarily on regimens recommended and used in the United States, where cost has traditionally not been a criterion for guideline selection. However, that may change as less expensive generic drugs become available.

US guidelines include those from the Department of Health and Human Services (DHHS), which are updated approximately once a year (Panel on Antiretroviral Guidelines for Adults and Adolescents 2015), and those from the International Antiviral Society (IAS-USA), updated every 2 years...

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   1,099.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   1,599.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Cahn P, Andrade-Villanueva J, Arribas JR, et al. Dual therapy with lopinavir and ritonavir plus lamivudine versus triple therapy with lopinavir and ritonavir plus two nucleoside reverse transcriptase inhibitors in antiretroviral-therapy-naïve adults with HIV-1 infection: 48 week results of the randomised, open label, non-inferiority GARDEL trial. Lancet Infect Dis. 2014;14:572–80.

    Article  CAS  PubMed  Google Scholar 

  • Clotet B, Feinberg J, van Lunzen J, et al. Once-daily dolutegravir versus darunavir plus ritonavir in antiretroviral-naïve adults with HIV-1 infection (FLAMINGO): 48 week results from the randomised open-label phase 3b study. Lancet. 2014;383:2222–31.

    Article  CAS  PubMed  Google Scholar 

  • Clumeck N, Molina JM, Henry K, et al. A randomized, double-blind comparison of single-tablet regimen elvitegravir/cobicistat/emtricitabine/tenofovir DF vs ritonavir-boosted atazanavir plus emtricitabine/tenofovir DF for initial treatment of HIV-1 infection: analysis of week 144 results. J Acquir Immune Defic Syndr. 2014;65:e121–4.

    Article  PubMed  Google Scholar 

  • Gallant JE, Koenig E, Andrade-Villanueva J, et al. Cobicistat versus ritonavir as a pharmacoenhancer for atazanavir plus emtricitabine/tenofovir DF in treatment-naïve HIV-1-infected patients: Week 48 results. J Infect Dis. 2013;208:32–9.

    Article  CAS  PubMed  Google Scholar 

  • Gunthard HF, Aberg JA, Eron JJ, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society-USA Panel. JAMA. 2014;312:1–17.

    Article  CAS  Google Scholar 

  • Lennox JL, Landovitz RJ, Ribaudo HJ, et al. Efficacy and tolerability of 3 nonnucleoside reverse transcriptase inhibitor sparing antiretroviral regimens for treatment-naive volunteers infected with HIV-1: a randomized, controlled equivalence trial. Ann Intern Med. 2014;161:461–71.

    Article  PubMed Central  PubMed  Google Scholar 

  • Panel on Antiretroviral Guidelines for Adults and Adolescents: Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-treatment-guidelines/0. Accessed 1 June 2015.

  • Raffi F, Babiker AG, Richert L, et al. Ritonavir-boosted darunavir combined with raltegravir or tenofovir-emtricitabine in antiretroviral-naive adults infected with HIV-1: 96 week results from the NEAT001/ANRS143 randomised non-inferiority trial. Lancet. 2014;384:1942–51.

    Article  CAS  PubMed  Google Scholar 

  • Sax PE, Tierney C, Collier AC, et al. Abacavir/lamivudine versus tenofovir DF/emtricitabine as part of combination regimens for initial treatment of HIV: final results. J Infect Dis. 2011;204:1191–201.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Walmsley SL, Antela A, Clumeck N, et al. Dolutegravir plus abacavir-lamivudine for the treatment of HIV-1 infection. N Engl J Med. 2013;369:1807–18.

    Article  CAS  PubMed  Google Scholar 

  • Wohl DA, Cohen C, Gallant JE, et al. A randomized, double-blind comparison of single tablet regimen elvitegravir/cobicistat/emtricitabine/tenofovir DF versus single tablet regimen efavirenz/emtricitabine/tenofovir DF for initial treatment of HIV-1 infection: analysis of week 144 results [letter]. J Acquir Immune Defic Syndr. 2014;65:3118–21.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joel Gallant .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Science+Business Media LLC

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Gallant, J. (2018). Initial Antiretroviral Regimens. In: Hope, T.J., Richman, D.D., Stevenson, M. (eds) Encyclopedia of AIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7101-5_445

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-7101-5_445

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-7100-8

  • Online ISBN: 978-1-4939-7101-5

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics