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Milos Opravil, Bernard Hirschel, Adriano Lazzarin, Hansjakob Furrer, Jean-Philippe Chave, Sabine Yerly, Leslie R. Bisset, Marek Fischer, Pietro Vernazza, Enos Bernasconi, Manuel Battegay, Bruno Ledergerber, Huldrych Günthard, Colin Howe, Rainer Weber, Luc Perrin, A Randomized Trial of Simplified Maintenance Therapy with Abacavir, Lamivudine, and Zidovudine in Human Immunodeficiency Virus Infection, The Journal of Infectious Diseases, Volume 185, Issue 9, 1 May 2002, Pages 1251–1260, https://doi.org/10.1086/340312
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Abstract
This randomized study evaluated the efficacy and tolerability of continued treatment with protease inhibitor plus nucleoside-analogue combination regimens (n = 79) or a change to the simplified regimen of abacavir-lamivudine-zidovudine (n = 84) in patients with suppressed human immunodeficiency virus type 1 (HIV-1) RNA for ⩾6 months who did not have the reverse transcriptase 215 mutation. After a median follow-up of 84 weeks, virologic failure was 6% in the continuation and 15% in the simplified group (P = .081). Previous zidovudine monotherapy or dual therapy and archived reverse transcriptase resistance mutations in HIV-1 DNA at baseline were significant predictors of failure. Study treatment was discontinued because of adverse events in 20% of the continuation and 7% of the simplified group (P = .021). Simplification to abacavir-lamivudine-zidovudine significantly decreased nonfasting cholesterol and triglyceride levels; however, this switch strategy carries a risk of virologic failure when treatment history or resistance testing suggest the presence of archived resistance mutations to the simplified regimen.