Evidence from 54 randomised controlled trials indicates that triple antiretroviral combination therapy is the choice for HIV positive patients who have received no previous antiviral treatment.
At the same time, there is a need for research on the effectiveness of quadruple therapies and the relative effectiveness of specific combinations of drugs, declares Dr Chris Hyde and colleagues at the Department of Public Health and Epidemiology, University of Birmingham, Birmingham, England.
Their conclusions are based on systematic review, meta-analysis, and meta-regression of fully reported randomised controlled trials involving more than 20,000 patients. All of the trials included comparison of quadruple versus triple therapy, triple versus double therapy, double versus monotherapy, or monotherapy versus placebo or no treatment.
Main outcomes measured were changes in the clinical outcomes of disease progression or death, and surrogate markers of CD4 count and plasma viral load.