Selecting a Treatment Regimen
Table 3. Antiretroviral Regimens for Antiretroviral Therapy- Naïve Patients (Updated October 2011)
Initiate therapy with 1 of the following 3 types of regimen:
Î NNRTI + 2 NRTIs OR Î PI (preferably boosted with RTV) + 2 NRTIs OR Î INSTI + 2 NRTIs • Selection of a regimen should be individualized based on virologic efficacy, toxicity, pill burden, dosing frequency, drug-drug interaction potential, resistance testing results, and comorbid conditions.
• Based on individual patient characteristics and needs, in some instances, an alternative regimen may actually be a preferred regimen for a patient.
Preferred Regimens (Regimens with optimal and durable efficacy, favorable tolerability and toxicity profile, and ease of use.) The preferred regimens for non-pregnant patients are arranged by order of FDA approval of components other than nucleosides, thus, by duration of clinical experience.
NNRTI-Based Regimen Î EFVa
/TDF/FTCb
INSTI-Based Regimen Î RAL + TDF/FTCb
(AI) (AI)
PI-Based Regimens (alphabetical order) Î ATV/rc
Î DRV/r (daily) + TDF/FTCb (twice daily) + ZDVe
+ TDF/FTCb (AI) (AI)
Preferred Regimen for Pregnancy Î LPV/r d
/3TCb (AI)
Alternative Regimens (Regimens that are effective and tolerable but have potential disadvantages compared with preferred regimens. An alternative regimen may be the preferred regimen for some patients.)
NNRTI-Based Regimens (alphabetical order) Î EFVa
Î RPVg/TDF/FTCb Î RPVg + ABCf/3TCb
+ ABCf /3TCb Î DRV/r + ABCf + ABCf (BI)
Î FPV/r (daily or bid) + (ABCf Î LPV/rd (daily or bid) + (ABCf
/3TCb (BIII)
NNRTI-Based Regimen Î EFVa
Î NVPh + (TDF/FTCb (CI)
+ ZDVe /3TCb
PI-Based Regimen Î ATVc, i
Î ATV/rc + ZDVe Î FPV/r + ZDVe Î LPV/rd + ZDVe
+ (ABCf /3TCb
(BI) - (BIII)
PI-Based Regimens (alphabetical order) Î ATV/rc
(BI)
/3TCb /3TCb
or TDF/FTCb or TDF/FTCb
) (BI) ) (BI)
Acceptable Regimens (Regimens that may be selected for some patients but are less satisfactory than preferred or alternative regimens.)
(CI)
or ZDVe /3TCb /3TCb /3TCb
or ZDVe (CI)
(CI) (CI)
/3TCb )/3TCb ) (CI)
CCR5 Antagonist-Based Regimen Î MVCj
+ ZDVe /3TCb (CI)
INSTI-Based Regimen Î RAL + ABCf
/3TCb (BIII)
4
