Is There a Best Regimen for Initial Antiretroviral Therapy?  Is
There a Best Regimen for Initial Antiretroviral Therapy?  Since
zidovudine became the first FDA-approved antiretroviral agent in
1987, an additional 25 antiretrovirals have been approved, as
well as a number of fixed-dose, coformulated, multidrug
combination products for the treatment of HIV infection. As a
result of combination antiretroviral  therapy (cART), HIV
infection has become a manageable chronic condition, with a life
expectancy in North America and Western Europe approaching that
of uninfected persons.  Various guidelines exist to help
clinicians choose initial cART. For instance, the US Department
of Health and Human Services (DHHS) Guidelines1 list a number of
“preferred” and “alternative” drugs or drug combinations, and
references the studies that support these recommendations. The
guidelines also list advantages and disadvantages of various
combinations. Nevertheless, no single combination is noted as
“the best” by any of the publi