Table 7. Advantages and Disadvantages of Antiretroviral
Components Recommended as Initial Antiretroviral Therapy
ARV
Agent(s) Advantages Disadvantages
Dual-NRTI pairs
a
(cont'd)
TDF/FTC
• Better virologic responses than
with ZDV/3TC
• Better virologic responses than
with ABC/3TC in patients
with baseline HIV RNA
>100,000 copies/mL in ACTG
5202 study; however, this was
not seen in the HEAT study
• Active against HBV;
recommended dual NRTI for
HIV/HBV coinfection
• Once-daily dosing
• No food effect
• Coformulated (TDF/FTC,
EFV/TDF/FTC, and RPV/
TDF/FTC)
• No cumulative TAM-mediated
resistance
• Potential for renal impairment,
including Fanconi syndrome
and acute renal insufficiency
• Early virologic failure of NVP
+ TDF + (FTC or 3TC) in
small clinical trials
• Potential for decrease in BMD
ZDV/3TC
• Coformulated (ZDV/3TC and
ZDV/3TC/ABC)
• No food effect (although better
tolerated with food)
• Preferred dual NRTI in
pregnant women
• Bone marrow suppression,
especially anemia and
neutropenia
• GI intolerance, headache
• Mitochondrial toxicity,
including lipoatrophy, lactic
acidosis, hepatic steatosis
• Compared with TDF/FTC,
inferior in combination with
EFV
• Less CD4 increase compared
with ABC/3TC
• Twice-daily dosing
a
Agents listed in alphabetical order.
Selecting a Treatment Regimen
28
