Atazanavir Plus Ritonavir or Efavirenz as Part of a 3-Drug Regimen for Initial Treatment of HIV-1: A Randomized Trial

Daar et al compare time to virologic failure; first grade-3 or -4 sign, symptom, or laboratory abnormality (safety); and change or discontinuation of regimen (tolerability) for atazanavir plus ritonavir with efavirenz-containing initial therapy for HIV-1. Results show that atazanavir plus ritonavir and efavirenz have similar antiviral activity when used with abacavir-lamivudine or tenofovir DF-emtricitabine. There were, however, differences between regimens in CD4 cell count increases, frequency of emergent resistance, rates of safety and tolerability events, and changes in fasting lipid levels and renal variables. These factors should be considered when selecting initial treatment of patients with HIV-1 infection.