Antiretroviral treatment simplification with 3 NRTIs or 2 NRTls plus nevirapine in HIV-1-infected patients treated with successful first-line HAART

Objectives: To assess the virologic noninferiority of an antiretroviral treatment simplification with coformulated zidovudine/lamivudine/abacavir (group 1) vs. coformulated zidovudine/lamivudine plus nevirapine (group 2) in HIV-1-infected patients receiving successful first-line highly active antiretroviral therapy. Methods: This is a prospective, multicenter, open-label, comparative, randomized, noninteriority study. A delta of 15% for differences in virologic suppression < 200 copies/mL between groups was pre-specified with a I-sided 0.025 significance level. Results: A total of 134 patients were included into this study: 68 were allocated to group I and 66 to group 2. By intention-to-treat analysis (switch equals failure), the percentage of virologic suppression < 200 copies/mL (< 50 copies/mL) at week 48 was 71.0% (65.1%) and 73.0% (63.3%) in groups I and 2, respectively (estimate for differences [< 200 copies/mL]: - 2.1, 95% CI: - 17.4-13.1, P = 0.783). Thirteen and 14 patients in groups 1 and 2, respectively, discontinued therapy due to adverse events. Dyslipidemia improved in both groups, with a higher improvement in low-density lipoprotein cholesterol (P = 0.049) in group 1. Conclusions: Group I is not inferior to group 2 regarding virologic suppression < 200 copies/mL. Both strategies improve lipid profile.