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Evidence summaries

Stavudine, Lamivudine and Nevirapine Combination Therapy for Treatment of HIV Infection and AIDS

The combination of nevirapine, lamivudine and stavudine appears to be as efficacious as a combination of efavirenz, lamivudine and stavudine in the treatment of HIV infection and AIDS. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 2 studies with a total of 1 276 subjects. In both trials over 60% of participants were male. The main findings are from the larger trial, which was of a high quality. This trial found that there was no statistically significant difference in the efficacy (measured by treatment failure) between nevirapine and efavirenz, when used in combination with lamivudine and stavudine (RR = 1.16; 95% CI 0.95 to 1.41). There was no statistically significant difference between once daily or twice-daily dosing of nevirapine, when used in combination with lamivudine and stavudine (RR = 1.00; 95% CI 0.83 to 1.21). Both once-daily (RR = 0.82; 95% CI 0.67 to 1.00) and twice-daily (RR = 0.82; 95% CI 0.69 to 0.97) dosing of nevarapine in combination with lamivudine and stavudine performed better than all four drugs nevarapine, efavirenz, lamivudine and stavudine together.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison). Nevirapine appeared to cause more adverse effects compared with efavirenz, but additional assessment of this is necessary to be more certain.

References

  • Siegfried NL, Van Deventer PJ, Mahomed FA, Rutherford GW. Stavudine, lamivudine and nevirapine combination therapy for treatment of HIV infection and AIDS in adults. Cochrane Database Syst Rev 2006 Apr 19;(2):CD004535. [PubMed]

Primary/Secondary Keywords