Let s drink to a new cocktail for HIV patients

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Thanks to continued advances in HIV treatment, patients who previously had to take 20 or more pills a day can now control their infections with a single daily cocktail drug. The first once-a-day therapy to hit the market was Atripla, which, when approved in 2006, vastly simplified the dosing schedules for many HIV-positive patients and is currently considered the gold standard regimen. And now another new once-daily pill called Quad consisting of four antiretroviral drugs is set to provide one more treatment option against the infection.

In a study published in this week s Lancet, researchers from Brigham and Women s Hospital and the Harvard Medical School compared the efficacy of the new Quad pill with two other first-line treatments in large randomized trials. In the first trial, 700 HIV-positive patients who had not been previously treated were assigned to receive either a daily dose of Quad or Atripla. After 48 weeks of treatment, findings showed that 88 percent of patients in the Quad group, versus 84 percent of the Atripla cohort, had lowered their viral loads to undetectable levels.

For the second trial, also consisting of about 700 newly-diagnosed HIV adults, patients received either a daily dose of Quad or another popular and recommended drug combination that s taken twice daily. Following about 4 months of treatment, 90 percent of the participants on Quad successfully suppressed their viral loads, compared to 87 percent of patients in the other group. Furthermore, the demonstrated safety of both therapies was comparable, as only 3.7 percent of Quad patients and 5.1 percent of adults in the alternate treatment group had to stop taking the drug.

Unlike Atripla a drug consisting of three antiretrovirals Quad contains a booster molecule called HIV integrase inhibitor. Thus, if approved, it would be the first single-tablet regimen with this element on the market. The availability of once-daily drug options is quite important in the treatment of HIV, since they improve both adherence and patient satisfaction while reducing prescription errors and the likelihood of drug resistance.

ACSH s Dr. Josh Bloom who worked in the antiretroviral field for many years thinks the latest Quad drug is a good addition to the already available therapies on the market: Another once-daily option is a great addition to the drug arsenal against HIV/AIDS. But the real breakthrough was the discovery of the component drugs a twenty year effort that make the current cocktails possible.