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Manufacturer: Bristol-Myers Squibb and Gilead Sciences

Each Atripla tablet contains 600 mg of Sustiva (efavirenz), 300 mg of Viread (tenofovir) and 200 mg of Emtriva (emtricitabine). Standard dose is one pill, once-a-day, usually taken before bedtime.

Evaluation: When it comes to HIV medications, it doesn’t get any better than this.Combination drugs are tremendously popular in the HIV community because they reduce the pill burden associated with the standard three-drug HIV “cocktail.” Atripla is the ultimate combination drug, combining a complete, effective HIV regimen into just one pill, taken just once-a-day. Atripla is the only drug on this list that does NOT need to be taken with at least one other HIV medication.

All three of the drugs in Atripla are listed as “preferred” in the latest Department of Health and Human Services (DHHS) guidelines for people just starting HIV treatment. People in the HIV community love this drug. It is listed first in this review because it is the single most attractive option available today.

Manufacturer: Gilead Sciences

Each Truvada capsule contains 200 mg of Emtriva (emtricitabine), and 300 mg of Viread (tenofovir). Standard dose is one capsule a day.

Evaluation: This is an outstanding combination drug that allows you to take two-thirds of your drug regimen in one pill, taken once-a-day. Truvada is the “preferred” dual-NRTI drug in the latest Department of Health and Human Services (DHHS) guidelines for people starting HIV treatment. Fantastic!

Manufacturer: GlaxoSmithKline

Each Epzicom tablet contains 300 mg of Epivir (lamivudine) and 600 mg of Ziagen (abacavir). Standard dose is one tablet a day.

Evaluation: This is a combination drug which, like Truvada, allows you to take two-thirds of your three-drug regimen in one pill, taken just once-a-day. Convenient? Yes!

Last year, Epzicom was upgraded from “alternative” to “preferred” in the DHHS guidelines, and here is the reason why. As with all products containing Ziagen, there is a risk of a hypersensitivity reaction, which may include fever, rash, fatigue, nausea, vomiting, diarrhea, and abdominal pain. This hypersensitivity reaction occurs in approximately 5%–8% of people who try Ziagen.

In the past, there was no way to predict who would have this allergic reaction to Ziagen, except by trial and error. That’s what made the drug less attractive than some others. But now there is a test that predicts who is allergic to Ziagen. The test is called the HLA-B*5701. Last year, Epzicom was considered a “preferred” drug for those who test negative for HLA-B*5701. (Those who test positive for HLA-B*5701 should not take the drug.)

In the current DHHS guidelines, however, Epizicom was dropped down to ‘alternative’ ranking again, because of concerns about cardiovascular risks raised by two new studies.

Manufacturer: GlaxoSmithKline

Each Combivir tablet contains 300 mg of Retrovir (zidovudine, AZT) and 150 mg of Epivir (lamivudine). Recommended dose is one tablet, twice a day. Combivir can be taken without regard to meals.

Evaluation: Combivir was approved by the Food and Drug Administration (FDA) in 1997, so it has been around for a long time. More clinical trials have used Combivir (in combination with various other medicines) than any other HIV drug.

However, in last year’s revision of the DHHS guidelines, Combivir was downgraded from “preferred” to “alternative.” It’s still a good drug, but it has more undesirable side-effects than the preferred two-drug combination, Truvada.

Manufacturer: GlaxoSmithKline

Trizivir is a combination of three HIV medicines. Each Trizivir tablet contains 300 mg of Retrovir (zidovudine, AZT), 150 mg of Epivir (lamivudine); and 300 mg of Ziagen (abacavir). Recommended dose is one tablet, two times a day. Can be taken without regard to meals.

Evaluation: Trizivir was an early attempt to put a complete, three-drug HIV cocktail into a single pill. It worked for a lot of people, but it is not as good as the more recent version of the same concept: Atripla is simply stronger and more effective than Trizivir. According to the latest DHHS guidelines, Trizivir is “generally not recommended and should only be used when a preferred or an alternative NNRTI-based or PI-based regimen is less desirable because of concerns about toxicities, drug interactions, or regimen complexity.”

Copyright 2010, Positive Health Publications, Inc.

This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!