Analysis TAF updated TDF only minor benefits

[Jim Allen]

Well interesting read that's for sure.

Its a long writeup :

https://www.poz.com/article/gileads-entire-hiv-enterprise-built-false-promise

In short:

British researchers who recently conducted an analysis of 11 randomized trials that compared TAF with TDF  among 8,111 people who were monitored for a cumulative 10,791 years. These investigators found that TAF was indeed associated with improved kidney and bone toxicities in trials that compared TAF and TDF. But such benefits were largely seen only when the drugs were used with so-called boosting agents, including Norvir (ritonavir) and Tybost (cobicistat), which are used in HIV treatment regimens to boost the body’s levels of ARVs. In comparison trials that did not include boosters, TAF offered only minor safety benefits over TDF.

“Gilead talks about this difference between the drugs, which we don’t think is real,” says the analysis’s lead author, Andrew Hill, MD, of the Department of Pharmacology and Therapeutics at the University of Liverpool in the United Kingdom. “We simply can’t see it. We’ve looked at all the available data. It’s all the clinical trials that exist.”

[gorka]

wondering what is now considered best regimen for drugs no longer under patent protection

[MitchMiller]

If you can take abacavir then once daily abacavir, epivir, sustiva (400mg) works well for me. 

The WHO study of 400mg sustiva was not with abacavir & epivir, but pairing it w/reduced dose sustiva works for me.  Reducing the dose of sustiva by 33% makes a huge difference for me.  I'm wondering why the dose wasn't 400mg to begin with.