Of five first-line antiretroviral (ARV) regimens considered in a South African modeling study, the one used most today—stavudine, lamivudine, and nevirapine—yielded the poorest quality-adjusted survival and cost more (in a cost-effectiveness analysis) than combined zidovudine, lamivudine, and nevirapine.
The World Health Organization (WHO) recommends four first-line regimens for resource-limited settings. WHO no longer recommends stavudine, lamivudine, and nevirapine, but that combination remains the most popular because of availability in a fixed-dose combination and a low wholesale cost. But the relative cost-effectiveness of these five regimens was not known until US researchers compared the five antiretroviral combinations.
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