ANTIVIRAL EFFECT OF DOUBLE AND TRIPLE-DRUG COMBINATIONS AMONGST HIV-INFECTED ADULTS - LESSONS FROM THE IMPLEMENTATION OF VIRAL LOAD-DRIVEN ANTIRETROVIRAL THERAPY

Objective: To study the antiviral effect and predictors of response to two-and three-drug regimens amongst antiretroviral-naive individuals using an intent-to-treat analysis. Main outcome measure: Suppression o f plasma viral load to <500 copies/ml. Patients: A total of 420 (264 d ouble drug, 156 triple drug) individuals in a province-wide treatment programme were studied. Results: A decrease in plasma viral load to <5 00 copies/ml was documented in 197 (47%) subjects. This was independen tly associated with a lower baseline plasma viral load (odds ratio, 3. 67; 95% confidence interval, 2.13-6.30) and initiation onto a three-dr ug regimen (odds ratio, 3.86; 95% confidence interval, 2.24-6.66). Med ian plasma viral load failed to reach <500 copies/ml and in fact rebou nded in the two-drug group. In contrast, 91 (58%) subjects receiving t hree drugs reached <500 copies/ml during the study period. Conclusion: These results support the use of powerful triple drug regimens as ini tial therapy in HIV-infected individuals.