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Comparing the efficacy of Truvada® and Kivexa® combination therapy in HAART-naive individuals with different viral loads

Purpose of the study

Truvada (emtricitabine + tenofovir) and Kivexa (abacavir + lamivudine) are combination therapies used as the nucleos(t)ide backbone in combination antiretroviral therapy. Recent reports have suggested Kivexa may be inferior to Truvada at high viral load (>100,000 copies/ml).

Methods

Retrospective case note review. All patients underwent HLA B5701 testing.

Summary of results

Between April 2006 and April 2008, 87 HAART-naive patients were commenced on either Truvada or Kivexa in combination with; efavirenz (53), nevirapine (3), Kaletra (6), atazanavir/ritonavir (9), other protease inhibitors (13). In the Truvada group (53), overall mean baseline viral load (VL) was 122,106 copies/ml. In the Kivexa group (33), overall mean baseline VL was 99,883 copies/ml. In order to assess the effect of different initial viral loads on the response to combination therapy, the patients were divided into three groups: those with High (>100,000 copies/ml), Intermediate (10,000 – 100,000 copies/ml) and Low (<10,000 copies/ml) viral loads prior to commencing HAART. (Table 1.)

Table 1

Failure to achieve a viral load of less than 1,000 copies/ml by 4 weeks of therapy is strongly associated with failure to achieve long-term viral suppression. In the Truvada group, 67% of all patients achieved this level by 4 weeks of therapy. In the Kivexa group, 70% of all patients achieved a viral load of <1,000 copies/ml after 4 weeks of therapy.

Conclusion

There is no significant difference in clinical practice when comparing the use of Truvada and Kivexa in patients with different viral loads at commencement.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Daniels, R., Gazzard, B., Holmes, P. et al. Comparing the efficacy of Truvada® and Kivexa® combination therapy in HAART-naive individuals with different viral loads. JIAS 11, P14 (2008). https://doi.org/10.1186/1758-2652-11-S1-P14

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  • DOI: https://doi.org/10.1186/1758-2652-11-S1-P14

Keywords

  • Viral Load
  • Lamivudine
  • Tenofovir
  • Efavirenz
  • Nevirapine