Twice-Daily Triple Nucleoside Intensification Treatment with Lamivudine-Zidovudine plus Abacavir Sustains Suppression of Human Immunodeficiency Virus Type 1: Results of the TARGET Study [Henry K, et al. JID 2001;183:571]: TARGET was a single-arm clinical trial of AZT/3TC/ABC in 87 patients who had been receiving one or two NRTIs with viral loads <50,000 c/mL and CD4 cell counts >50/mm³. The median HIV level at baseline was 3.1 log₁₀ c/mL, including 34% of patients with levels <400 c/mL and 11% with levels <50 c/mL; the median CD4 cell count was 506/mm³. Results by intent-to-treat analysis after 48 weeks on triple nucleoside therapy showed a viral load <400 c/mL in 82% and <50 c/mL in 56%. Previous exposure to AZT or 3TC, or the presence of M184V mutation did not alter virologic results.
Comment: The results in this study are comparable to those achieved in many trials with traditional "triple-therapy" using two NRTIs plus a PI or an NNRTI. It should be acknowledged that these patients had baseline values that would predict long-term success: a median VL of about 1200 c/mL on one or two nucleosides, and a CD4 cell count >500/mm³. Nevertheless, the results are encouraging with respect to Trizivir, the most simple antiretroviral regimen to date. Also encouraging was the 48-week data showing no increase in serum cholesterol, triglycerides, or glucose.
posted 3/1/2001

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