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Volume 349:2460-2461 December 18, 2003 Number 25
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Substitution for Protease Inhibitors in HIV Therapy

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 by Martínez, E.
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To the Editor: Martínez et al. (Sept. 11 issue)1 report that among patients who switched to efavirenz from a protease inhibitor, 29 (18.6 percent) subsequently discontinued efavirenz without virologic failure. This proportion is considerably in excess of that reported by Staszewski et al. in the pivotal study that established the superior efficacy of efavirenz in comparison with indinavir (4 percent).2

My colleagues and I have found that switching to efavirenz from a protease inhibitor is less well tolerated by patients who have acquired human immunodeficiency virus (HIV) infection through intravenous drug use than by other patients, with a 25 percent . . . [Full Text of this Article]




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