Once-daily antiretroviral therapy in HIV gains favor for adherence. (Low Pill Burden).

SAN DIEGO -- A trend toward once-daily antiretroviral therapy for HIV gained some ground with new data from several studies reported at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy

A once-daily dosage of 200 mg emtricitabine, an investigational nucleoside reverse transcriptase inhibitor (NRTI), worked as well as twice-daily doses of the commonly used NRTI stavudine (d4T) to reduce HIV viral load to below detectable limits in a randomized, double-blind, multicenter study of 571 patients, reported Dr. Michael S. Saag of the University of Alabama, Birmingham. All patients also received daily open-label doses of didanosine (ddI) and efavirenz.

Patients started with HIV-1 RNA loads of greater than 5,000 copies/mL. After 24 weeks, an intent-to-treat analysis found that 81% in the emtricitabine group and 70% in the d4T group had viral loads below the limit of detection (50 copies/mL), said Dr. Saag, who is an advisor to Triangle Pharmaceuticals Inc., which makes emtricitabine and funded the study and to Bristol-Myers Squibb Co., which makes the other drugs used in the study.

Success with the once-daily regimen probably is due to its greater convenience, Dr. Saag said.

A second prospective, randomized study in Italy compared three open-label antiretroviral regimens in 102 HIV-infected patients. The once-daily regimen contained ddI, lamivudine (3TC), and efavirenz. This was compared with two twice-daily regimens, one with a "low pill burden" consisting of ...