Nevirapine-Based Regimens Best for HIV Infection With Subclinical Viral Load

Feb 11 - An ultrasensitive assessment of HIV-RNA levels in HAART-treated patients with subclinical viral loads reveals that nevirapine-based regimens are more effective in this setting than those based on efavirenz or lopinavir/ritonavir.

The findings come from a study of 154 HIV-infected patients who were classified as full treatment responders as their HIV-RNA levels were below 50 copies/mL. While this has been the standard target for antiretroviral therapy, in the last few years, tests have become available that can detect HIV-RNA levels as low as 2 copies/mL.

As reported in the March issue of the Journal of Medical Virology, Dr. Stefano Bonora, from the University of Torino, Italy, and colleagues used an ultrasensitive assay (detection limit = 2.5 copies/mL) to assess HIV-RNA levels in the study group. The subjects included 48 treated with nevirapine, 57 with efavirenz, and 49 with lopinavir/ritonavir, in addition to two nucleoside/nucleotide reverse transcriptase inhibitors.

Overall, 60.4% of nevirapine-treated subjects, 42.1% of those given efavirenz, and 28.6% of those treated with lopinavir/ritonavir had undetectable HIV-RNA levels, i.e., below 2.5 copies/mL.