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Standard practice

Current DHHS treatment guidelines for first time therapy*

* Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. October 14, 2011; 1-167. Available at here. Accessed February 21, 2012; page 43; Table 5a.

Index of abbreviations

Patients new to antiretroviral therapy should start on one of three types of combination regimens: graphic depictin an NNTRI-Based Regimen, a PI-based regimen, and an INSTI-baes regimen

PREFERRED REGIMENS
NNRTI-BASED Sustiva (EFV)1 + Truvada (TDF/FTC)3
PI-BASED

Boosted Prezista (DRV/r) + Truvada (TDF/FTC)3
Boosted Reyataz (ATV/r) + Truvada (TDF/FTC)3
INSTI-BASED Isentress (RAL) + Truvada (TDF/FTC)3
PREFERRED FOR PREGNANT WOMEN
PI-BASED Kaletra (LPV/r) (twice daily) + Combivir (ZDV/3TC)3
ALTERNATIVE REGIMENS
NNRTI-BASED

Edurant (RPV) + Epzicom or Truvada (TDF/FTC)3
Sustiva (EFV) + Epzicom (ABC/3TC)3
PI-BASED

Kaletra (LPV/r) (once or twice daily) + Epzicom (ABC/3TC)3 or Truvada (TDF/FTC)3
Boosted Lexiva (FPV/r) (once or twice daily) + Epzicom or Truvada
Boosted Prezista (DRV/r) + Epzicom (ABC/3TC)3
Boosted Reyataz (ATV/r) + Epzicom (ABC/3TC)3
INSTI-BASED Isentress (RAL) + Epzicom (ABC/3TC)3
ACCEPTABLE REGIMENS
NNRTI-BASED Edurant (RPV) + Combivir (ZDV/3TC)3
Sustiva (EFV) + Combivir (ZDV/3TC)3
Viramune (NVP)2 + Combivir or Epzicom or Truvada
PI-BASED

Kaletra (LPV/r) + Combivir (ZDV/3TC)3
Boosted Lexiva (FPV/r) + Combivir (ZDV/3TC)3
Boosted Prezista (DRV/r) + Combivir (ZDV/3TC)3
Boosted Reyataz (ATV/r) + Combivir (ZDV/3TC)3
Reyataz (ATV) + Epzicom or Combivir (ABC or ZDV/3TC)3
CCR5 Antagonist-based regimens Selzentry (MVC) + Combivir (ZDV/3TC)3
MAY BE ACCEPTABLE, BUT MORE DATA NEEDED
CCR5 Antagonist-based regimens Selzentry (MVC) + Truvada (TDF/FTC)3 or Epzicom or Combivir (ABC or ZDV/3TC)3
MAY BE ACCEPTABLE, BUT USE WITH CAUTION
CCR5 Antagonist-based regimens

Boosted Invirase (SQV/r) + Epzicom or Combivir (ABC or ZDV/3TC)3
Boosted Invirase (SQV/r) + Truvada (TDF/FTC)3
  1. Except during first trimester of pregnancy or in women with high pregnancy potential
  2. Viramune (nevirapine) should not be initiated in women with CD4+ T-cell count greater than 250 cells/mm3 or in men with CD4+ T-cell count greater than 400 cells/mm3
  3. Emtriva (emtricitabine) and Epivir (lamivudine) are interchangeable.

ABBREVIATIONS:

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