In a head-to-head comparison of three drugs presented at the 21st Conference on Retroviruses and Opportunistic Infections (CROI) on Wednesday, the integrase inhibitor (II) raltegravir (Isentress) proved to be superior, in terms of the overall likelihood of treatment failure, when compared to the two ritonavir-boosted protease inhibitors (PIs) atazanavir (Reyataz) and darunavir (Prezista). All three drugs were taken alongside tenofovir and FTC (co-formulated in Truvada). This study is important because it may lead to changes in recommendations for first-and second-line drugs in treatment guidelines. In short, raltegravir was shown to be superior to both atazanavir/ritonavir and darunavir/ritonavir when considering virological and toxicity failure together in this study. These two are the most widely used first-line (initial) ART drugs at present. This finding is likely to be taken into account the next time HIV treatment guidelines are revised.
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