A Smart + Strong Site
Subscribe to:
E-newsletters
POZ magazine
JOIN AIDSMEDS YouTube

Back to home » Treatment News » Top Stories

Most Popular Stories
An Almost Normal Life Expectancy for People With HIV?
Undetectable Viral Load Essentially Eliminates Transmission Risk in Straight Couples
A 15-Year Jump in Life Expectancy for People With HIV
Misleading News Reports Suggest HIV Cure Is Near
New HIV Drug Class Shows Promise
Gene Therapy Shows Promise in Controlling HIV
Potential Microbicide Tricks HIV Into Sudden Death
What's That Mean?
(just double-click it!)

If you don't understand one of the words in this article, just double-click it. A window will open with a definition from mondofacto's On-line Medical Dictionary. If the double-click feature doesn't work in your browser, you can enter the word below:

Most Popular Lessons
Aging & HIV
The HIV Life Cycle
Shingles
Herpes Simplex Virus
Syphilis & Neurosyphilis
Treatments for Opportunistic Infections (OIs)
What is AIDS & HIV?
More News

Have medical or treatment news about HIV? Send press releases, news tips and other announcements to news@aidsmeds.com.

Click here for more news


emailprint

July 1, 2011

Abacavir Should (Again) Be a “Preferred” HIV Treatment Option

Researchers of a new study, published online June 24 in the Journal of Acquired Immune Deficiency Syndromes, found similar rates of treatment success in people taking abacavir plus lamivudine (Epzicom), compared with people taking tenofovir plus emtricitabine (Truvada). Moreover, they conclude that abacavir should once again be listed as a “preferred” option in HIV treatment guidelines.

Three landmark studies during the past three years resulted in the down-grading of abacavir in U.S. HIV treatment guidelines from a “preferred” antiretroviral (ARV) agent for first-line therapy, notably when used in the combination tablet Epzicom, to an “alternative” agent.

Two of those studies, SMART and D:A:D, suggested that people taking abacavir had a higher rate of heart attacks than people on other nucleoside reverse transcriptase inhibitors (NRTIs). A third study, ACTG 5202, found that people on an Epizcom-inclusive regimen for first-line therapy were more likely to experience treatment failure upon starting therapy with a high viral load (over 100,000 copies), compared with people taking a Truvada-inclusive regimen.

Though other studies found no association between abacavir and heart attacks, nor lower efficacy in people starting treatment with high viral loads, the panel of experts and community activists who write U.S. guidelines voted to downgrade Epzicom in 2008. Truvada, however, has remained the preferred NRTI option.

Given the mixed results of these various studies, several European guidelines committees decided not to follow suit and kept Epzicom—branded as Kivexa in Europe—as a preferred regimen. The competing studies and differing guidelines have led to confusion as to the best use of Epizcom in people starting treatment for the first time.

In hopes of clarifying the efficacy of abacavir compared with tenofovir—less concern exists for lamivudine or emtricitabine, as both drugs are very similar—Darrell Tan, MD, from the University of Toronto, and his Canadian colleagues, examined the medical records of 1,764 HIV-positive people who started HIV treatment between 2000 and 2010. An earlier look at the data in a smaller group of people was reported in 2010 at the International AIDS Conference in Vienna.

The Canadian Institutes of Health funded the study, and no conflicts of interest with Epzicom’s manufacturer, ViiV Healthcare, were reported.

For the study, Tan’s group directly compared people starting a regimen including abacavir and lamivudine—either separately as Ziagen and Epivir or as Epzicom—with those starting a regimen including tenofovir and emtricitabine—either separately as Viread and Emtriva, or together as Truvada. After Atripla, a combination tablet containing tenofovir, emtricitabine and efavirenz, became available in Canada in 2007, those taking the three-in-one tablet were included in the tenofovir group.

Tan found that when multiple variables were considered, people taking an abacavir regimen were no more likely to experience treatment failure than those taking a tenofovir regimen. This held true even in people who started treatment with viral loads over 100,000.

What’s more, the rate at which people were able to suppress their virus over the first few months of treatment—another way of looking at the potency of the treatment regimen—was equivalent between the two groups.

Lastly, people taking abacavir were no more likely to switch or stop treatment for reasons other than virological failure than people taking tenofovir.

Tan’s team acknowledges that a primary difference between ACTG 5202 and their study is the fact that people in ACTG 5202 were randomized to receive either abacavir or tenofovir, whereas in their study no randomization occurred. This means that there might have been reasons that a person’s provider chose one of the regimens over the other and that these reasons could have affected Tan’s study results. Because of this, the authors state that their study cannot say conclusively that abacavir and tenofovir are equivalent in terms of efficacy.

Other features of the Canadian study, however, were similar to ACTG 5202, and the Canadian study’s results are similar to a different clinical trial, the HEAT study, which found that abacavir was equivalent to tenofovir, even in people with high viral loads. Therefore, the authors conclude: “These results support the use of either NRTI backbone in the initial therapy of ART-naïve patients, and would support continuing [abacavir/lamivudine] as a ‘preferred’ NRTI option.”

Search: abacavir, ziagen, epzicom, dhhs, preferred, D:A:D, SMART, ACTG 5202


Scroll down to comment on this story.



Name:

(will display; 2-50 characters)

Email:

(will NOT display)

City:

(will display; optional)

Comment (500 characters left):

(Note: The AIDSmeds team reviews all comments before they are posted. Please do not include ":" "@" "<" ">" in your comment. The opinions expressed by people providing comments are theirs alone. They do not necessarily reflect the opinions of Smart + Strong, which is not responsible for the accuracy of any of the information supplied by people providing comments.)

Comments require captcha.
Please enter this number for verification:

| Posting Rules



Show comments (1 total)


[Go to top]

Quick Links
AIDSmeds en Español
About HIV and AIDS
Lab Tests
Clinical Trials
HIV Meds
Starting Treatment
Switching Treatment
Drug Resistance
Side Effects
Disclosure
Lipodystrophy
Hepatitis & HIV
Women & Children
Fact Sheets
Treatment News
Community Forums
Blogs
Conference Coverage
Health Services Directory
POZ Magazine


    acousticmat
    Tucson
    Arizona


    Loveladyd
    Washington
    DC


    hollywoodvers1
    Los Angeles
    California


    blaze11212
    brooklyn
    New York
Click here to join POZ Personals!
Conference Coverage

21st Conference on Retroviruses and Opportunistic Infections
(CROI 2014)
Boston, MA
March 3 - 7, 2014


7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention
(IAS 2013)
Kuala Lumpur, Malaysia
June 30 - July 3, 2013


20th Conference on Retroviruses and Opportunistic Infections
(CROI 2013)
Atlanta, GA
March 3 - 7, 2013


more conference coverage

[ about AIDSmeds | AIDSmeds advisory board | our staff | advertising policy | advertise/contact us]
© 2014 Smart + Strong. All Rights Reserved. Terms of use and Your privacy.
Smart + Strong® is a registered trademark of CDM Publishing, LLC.