HIV Digest	HIV Digest Archive

Some triple-drug combinations not including a protease inhibitor have been proposed as "protease sparing" regimens, for certain patients who might want to start with a somewhat easier combination treatment and/or save the protease inhibitors for later. One arm of a yearlong study recently published in Journal of the American Medical Association (JAMA) , which treated 51 volunteers with AZT plus ddI plus nevirapine, found that viral load was undetectable for one year in about half of those treated. The patients in this study were among the easiest to treat, however-- as they were antiretroviral naive, and also had not had any AIDS-defining diagnosis.

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An accompanying editorial in JAMA concluded, "Currently, for patients with advanced HIV disease or AIDS, effective antiretroviral therapy requires starting treatment with a regimen that includes a protease inhibitor. For patients with earlier stages of HIV disease, the choice among currently available regimens should be carefully considered, with easier-to-take regimens kept in mind. The philosophy of 'treat early, treat hard' in early HIV infection must now yield to a philosophy of 'treat smart' for all stages of HIV infection."

Editor's Note: from AIDS Treatment News