Rilpivirine (TMC278), a nonnucleoside being developed for first-line therapy, sustained 48-week response rates through 96 weeks in a phase-2 comparison with efavirenz [1]. Certain side effects were more limited with rilpivirine than with efavirenz.
An international cast of investigators randomized 368 antiretroviral-naive people to start 25, 75, or 150 mg of rilpivirine once daily or standard-dose once-daily efavirenz plus two nucleosides--zidovudine/lamivudine in 76% and tenofovir/emtricitabine in 24%. One third of study participants were women, and just under half were Caucasian. Pretreatment viral load averaged about 70,000 copies in the combined rilpivirine groups and the efavirenz group, and starting CD4 count averaged about 200.
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