LPV/r+EFV is not ranked among the regimens in the DHHS Decision Guidelines, but nonetheless has clinical evidence in its favor. In a trial comparing LPV/r+EFV to either LPV/r or EFV with two NRTI’s the NRTI-sparing regimen demonstrated comparable virological efficacy at 112 weeks although it was more likely to be associated with drug resistance (Riddler 2008). Many experts consider DRV/r to be a preferable PI to LPV/r, though specific clinical trial data for the EFV+DRV/r regimen is lacking.
Efficacy in clinical trials:
- At a median follow up of 112 weeks the virological efficacy of LPV/r+EFV was similar to that of EFV or LPV/r plus two NRTI’s. However, the NRTI-sparing regimen was more likely to be associated with drug resistance (Riddler 2008).
- Riddler SA, Haubrich R, DiRienzo AG, Peeples L, Powderly WG, Klingman KL, Garren KW, George T, Rooney JF, Brizz B, et al: Class-sparing regimens for initial treatment of HIV-1 infection. N Engl J Med 2008, 358:2095–2106.
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