New options in 2008

In 2008 treatment guidelines may change following research into new drugs.

• Atripla – (a single pill that includes efavirenz+ tenofovir+FTC) is now approved in Europe.
  People taking a first-line combination of efavirenz and Truvada, with an undetectable viral load for three months, can switch to Atripla
• Atazanavir/r for first-line therapy is currently being researched, and the results are expected shortly. Although atavanavir/r is widely used as first line treatment, it is not approved in Europe for this purpose.
• Darunavir/r was approved as a treatment for people with resistance.However, in a recent study, darunavir did better than Kaletra as first therapy, and future guidelines should reflect this.
• Raltegravir – (an integrase inhibitor) has shown similar potency to efavirenz, but has fewer side effects or interactions with other drugs.
  This drug was first studied as a treatment for people with drug resistance, but it could also be as good as efavirenz in first-line treatment.
• Maraviroc – (an entry inhibitor) did not do as well as efavirenz in first line therapy. Further research may show that this is a option for some patients.
• Etravirine - (a new NNRTI) may be an option for people who have NNRTI resistance before they start treatment.

How widely these new drugs will be used is also likely to be related in part to cost.

If they are more expensive than existing treatment, they may only be used when people cannot tolerate current drugs – especially if they do not show clear advantages.

Even if they are not used to start with, it is important to know that they will be options in case you need to switch treatment.

This is the web edition of the i-Base guide Introduction to combination therapy. This guide is available in UK clinics. You can order free printed copies or download a PDF version (516 Kb). Translations. Authors and credits. Glossary. Full section index.

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.