Dual therapy with lopinavir and ritonavir plus lamivudine versus triple therapy with lopinavir and ritonavir plus two nucleoside reverse transcriptase inhibitors in antiretroviral-therapy-naive adults with HIV-1 infection: 48 week results of the randomised, open label, non-inferiority GARDEL trial

Plasma Micronutrient Concentrations Are Altered by Antiretroviral Therapy and Lipid-Based Nutrient Supplements in Lactating HIV-Infected Malawian Women

“…Our finding that protease inhibitor-based therapy was associated with lower folate concentrations confirms results from small cross-sectional studies in children and adults (35,36). Lower folate concentrations among participants receiving HAART could be related to poor absorption due to drug-related changes in gut epithelial integrity (37) or drug-related diarrhea, which commonly occurs with initiation of protease inhibitors and some other antiretroviral drugs (38,39). It is possible that HAART is related to intracellular folate metabolism.…”

Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

“…56 To date, only 2 adequately powered randomized clinical trials have demonstrated noninferior outcomes of 2-drug therapy compared with 3-drug regimens. Lopinavir/r plus lamivudine was noninferior to lopinavir/r plus 2 NRTIs in one study, 57 and darunavir/r plus raltegravir was noninferior to darunavir/r plus 2 NRTIs in another. 58 However, these 2-drug regimens have limitations.…”

“…Of note, there are no adequately powered studies of initial therapy of other listed 2-drug regimens besides darunavir/r plus raltegravir or lopinavir/r plus lamivudine; efficacy is assumed from other clinical trials. 57,58 …”

HIV and Aging – Perhaps Not as Dramatic as We Feared?

“…Finally, some HIV clinicians actively stop the “third agent” (TDF, ABC) for reasons of bone, renal, and CV health, arguing that evidence from randomized trial for the virological efficacy of dual therapy – using, e.g., 3TC and a protease inhibitor – is now solid [61, 62]. Those who avoid protease inhibitors are now using 3TC or FTC in combination with dolutegravir with success (dolutegravir monotherapy is not recommended today because the virological failure rate is too high), and virological failure with such dual therapy has been rare [63].…”