Nevirapine / Lamivudine for HIV Maintenance Therapy

The standard treatment for HIV infection involves taking a combination of three HIV drugs. The main reason for using multiple substances is to prevent resistance from developing rapidly when only one or two drugs are used. However, in recent years, studies have shown that the risk of resistance developing is significantly lower once viral replication in the body has been completely suppressed. Studies have now been conducted on this maintenance therapy phase, which aims to reduce the number of drugs used. Some positive results have been reported with monotherapy. There have been positive results with both protease and integrase inhibitors. However, both groups of drugs demonstrate monotherapy failure in 10-20% of patients. We suspect that poor penetration into the genital tract and brain is partly responsible for this. In contrast, recent studies on the dual combination of protease or integrase inhibitors with lamivudine have demonstrated excellent efficacy. Lamivudine is known to work very well in the brain and genital tract. Since HIV medication must be taken for life, simplifying therapy is very important. This reduces the potential for long-term side effects and costs. The Clinic for Infectious Diseases and Hospital Hygiene at the Cantonal Hospital of St. Gallen in Switzerland has many years of experience with nevirapine, an HIV medication introduced over 20 years ago. One third of patients are treated with this substance. Of the additional preparations used in combination with nevirapine, one contains lamivudine (or its analogue, emtricitabine), plus either abacavir or tenofovir. The latter two have potentially significant long-term side effects, including an increased risk of cardiovascular disease and kidney/bone toxicity. A dual combination of nevirapine and lamivudine is highly likely to be effective. Furthermore, it is the most favourable of all the alternative combinations. Based on current knowledge, this combination appears to have no long-term sid