HIV-positive women do better starting their first antiretroviral (ARV) regimen with Triumeq (dolutegravir/abacavir/lamivudine) than with Norvir (ritonavir)–boosted Reyataz (atazanavir) plus Truvada (tenofovir disoproxil fumarate/emtricitabine). Researchers in the international, open-label Phase IIIb ARIA study randomized 495 treatment-naive women, one-to-one, to start taking Triumeq or the latter regimen.

The two groups were well matched according to demographics and other characteristics upon starting the study.

The researchers found that Triumeq offered a superior viral suppression rate among the partcipants after 48 weeks of treatment: 82 percent, compared with 71 percent among those on Norvir–boosted Reyataz plus Truvada. The lower viral suppression rate was driven by higher rates of people stopping treatment because of side effects and virologic failures. Increases in CD4 count were similar between the two groups.

Triumeq was also safer than Norvir–boosted Reyataz plus Truvada; fewer people experienced medication-related adverse health events: 33 percent and 49 percent, respectively. A respective 4 percent and 7 percent dropped out of the study because of adverse health events.

Side effects experienced by those taking Triumeq included: nausea (13 percent), diarrhea (5 percent), headache (2 percent) and indigestion (2 percent). Among those taking the alternative regimen, side effects included nausea (14 percent), diarrhea (7 percent), jaundice of the eye (7 percent), indigestion (6 percent), headache (6 percent) and jaundice (5 percent).

Six percent of those taking Triumeq had a detectable viral load at week 48, compared with 14 percent of those taking Norvir–boosted Reyataz plus Truvada.

Of the six people who experienced virologic failure on Triumeq, none had emergent primary resistance mutations to integrase strand transfer inhibitors (ISTIs, a class that includes dolutegravir) or to abacavir and lamivudine.