HIV Digest	HIV Digest Archive

One of the most important treatment developments at the 12th World AIDS Conference (Geneva, June 28 - July 3) was the report of new phase III data showing that efavirenz (brand name Sustiva, formerly known as DMP-266), used in combination with other treatment, may suppress viral load at least as well as the protease inhibitor indinavir (Crixivan) in the equivalent combination with nucleoside reverse transcriptase inhibitors. The data was from a head-to-head comparison trial in volunteers with little or no previous antiretroviral treatment.

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Of course much remains to be learned about the benefits and drawbacks of each antiretroviral treatment, but a widespread consensus at the conference seemed to accept efavirenz combinations as now "on the table" for consideration among other major treatment options, which until now have mostly been built around protease inhibitors. Efavirenz is a non-nucleoside reverse transcriptase inhibitor (NNRTI), like nevirapine or delavirdine.

One concern about efavirenz is that it may be unlikely to work in patients who have already developed resistance to either nevirapine or delavirdine, the two NNRTI drugs currently approved in the U.S. It is, therefore, particularly important to use any NNRTI correctly, and in a maximally suppressive regimen, to minimize the chance of developing resistant HIV.

Efavirenz is currently available through expanded access programs; for more information, call the Sustiva Expanded Access Program, 800-998-6854 (8 am to 6 pm, Monday through Friday, from the US or Canada) or in Europe call 44-01-462-488263. Additional information about the Geneva efavirenz presentations is available on the Web. Go to hopkins-aids.edu/geneva/info.html.

Editor's Note: from AIDS Treatment News