Selecting a Treatment Regimen
Table 2. Advantages and Disadvantages of Antiretroviral
Components Recommended as Initial Antiretroviral
Therapy
ARV
Class
ARV
Agent(s) Advantages Disadvantages
Dual- NRTI
Pairs
ABC/3TC • Once-daily dosing
• No food effect
• No nephrotoxicity
• Inferior virologic
responses in patients
with baseline HIV RNA
≥100,000 copies/mL
when given with EFV
or ATV/r as compared
with TDF/FTC in
ACTG 5202 study. This
difference not seen when
ABC/3TC was used in
combination with DTG.
• Requires HLA-B*5701
testing before use
• Potential for ABC
HSR in patients with
HLA-B*5701 allele
• ABC use has been
associated with cardiac
events in some but not
all observational studies.
TDF/FTC • Better virologic responses
than with ABC/3TC
in patients with baseline
viral load ≥100,000
copies/mL when
combined with ATV/r
or EFV
• Active against HBV;
recommended dual-
NRTI for HIV/HBV
co-infected patients
• Once-daily dosing
• No food effect
• Co-formulated in
fixed-dose combinations
that comprise an entire
regimen in a single pill
(EFV/TDF/FTC, EVG/
cobi/TDF/FTC, and
RPV/TDF/FTC)
• Potential for renal
impairment, including
proximal tubulopathy
and acute or chronic
renal insufficiency
• Potential for decrease in
BMD
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