美国研究人员2003年12月表示，他们已经制定出治疗爱滋病（AIDS）的“最佳”鸡尾酒疗法，并开始在患者身上使用，这一疗法可以抑制病毒的时间最长，且副作用最小。

这一鸡尾酒疗法配方中，包括有最先使用的抵御爱滋病毒（HIV）药物——葛兰素史克（GlaxoSmithKline，GSK）出品的AZT，也被称为齐多夫定（Zidovudine）；被称为拉米夫定（lamivudine）或3TC的葛兰素药品贺普丁（Epivir）；还有百时美施贵宝（Bristol Myers Squibb，BMY）制造，品名为施多宁（Sustiva）的依法韦伦（efavirenz）药物。

研究人员表示，这项由政府资助的研究旨在帮助医生和患者从多达19种的HIV药物中作出选择。这些报告刊载于《新英格兰医学杂志》（New England Journal of Medicine）上。

“这些发现提供了新的想法，帮助此前未获治疗的HIV感染者找到最有效的治疗方式，”美国国家过敏及传染病研究所（National Institute of Allergy and Infectious Diseases）主任佛西博士（Dr.Anthony Fauci）通过一份声明表示。

“在此之前，研究人员并不清楚何种组合次序的抗逆转录病毒疗法，能够为未曾接受治疗的患者提供最佳疗效。”领导其中一项研究的麻省综合医院和哈佛医学院的罗宾斯博士（Dr. Gregory Robbins）表示。

N Engl J Med. 2003 Dec 11;349（24):2293-303.

Comparison of Sequential Three-Drug Regimens as Initial Therapy for HIV-1 Infection

Gregory K. Robbins, Victor De Gruttola, Robert W. Shafer, Laura M. Smeaton, M.S., Sally W. Snyder, Carla Pettinelli, Michael P. Dube, Margaret A. Fischl, Richard B. Pollard, Robert Delapenha, Linda Gedeon, Charles van der Horst, Robert L. Murphy, Mark I. Becker, PharRichard T. D'Aquila, Stefano Vella, Thomas C. Merigan, Martin S. Hirsch, for the AIDS Clinical Trials Group 384 Team

Harvard Medical School and Harvard School of Public Health — both in Boston; Stanford University Medical Center, Stanford, Calif.; Social & Scientific Systems, Silver Spring, Md.; Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.; Indiana University School of Medicine, Indianapolis; University of Miami School of Medicine, Miami; University of California–Davis Medical Center, Sacramento; Howard University, Washington, D.C.; Frontier Science & Technology Research Foundation, Amherst, N.Y.; University of North Carolina School of Medicine, Chapel Hill; Northwestern University, Chicago; Agouron Pharmaceuticals, La Jolla, Calif.; Vanderbilt University Medical Center, Nashville; and Istituto Superiore di Sanita, Rome.

Address reprint requests to Dr. Robbins at Massachusetts General Hospital, Infectious Disease Unit, 55 Fruit St., Boston, MA 02114, or at grobbins@partners.org.

Background The optimal sequencing of antiretroviral regimens for the treatment of infection with human immunodeficiency virus type 1 （HIV-1) is unknown. We compared several different antiretroviral treatment strategies. Methods This multicenter, randomized, partially double-blind trial used a factorial design to compare pairs of sequential three-drug regimens, starting with a regimen including zidovudine and lamivudine or a regimen including didanosine and stavudine in combination with either nelfinavir or efavirenz. The primary end point was the length of time to the failure of the second three-drug regimen. Results A total of 620 subjects who had not previously received antiretroviral therapy were followed for a median of 2.3 years. Starting with a three-drug regimen containing efavirenz combined with zidovudine and lamivudine （but not efavirenz combined with didanosine and stavudine) appeared to delay the failure of the second regimen, as compared with starting with a regimen containing nelfinavir （hazard ratio for failure of the second regimen, 0.71; 95 percent confidence interval, 0.48 to 1.06), as well as to delay the second virologic failure （hazard ratio, 0.56; 95 percent confidence interval, 0.29 to 1.09), and significantly delayed the failure of the first regimen （hazard ratio, 0.39) and the first virologic failure （hazard ratio, 0.34). Starting with zidovudine and lamivudine combined with efavirenz （but not zidovudine and lamivudine combined with nelfinavir) appeared to delay the failure of the second regimen, as compared with starting with didanosine and stavudine （hazard ratio, 0.68), and significantly delayed both the first and the second virologic failures （hazard ratio for the first virologic failure, 0.39; hazard ratio for the second virologic failure, 0.47), as well as the failure of the first regimen （hazard ratio, 0.35). The initial use of zidovudine, lamivudine, and efavirenz resulted in a shorter time to viral suppression. Conclusions The efficacy of antiretroviral drugs depends on how they are combined. The combination of zidovudine, lamivudine, and efavirenz is superior to the other antiretroviral regimens used as initial therapy in this study.