Lowering the toxicity level of HIV drugs benefits younger patients with HIV, and may yield greater health implications for all HIV-positive patients, according to researchers.

“Many analyses of HIV treatment decisions assume a fixed formulary of HIV drugs,” wrote Mark Roberts, MD, MPP of the University of Pittsburgh and colleagues. “However, new drugs are approved nearly twice a year, and the rate of availability of new drugs may affect treatment decisions, particularly when to initiate antiretroviral therapy (ART).”

To determine the impact of considering the availability of new drugs on the optimal initiation criteria for ART and outcomes in patients with HIV/AIDS, researchers ran a simulation model incorporating the rate of availability of new antiviral drugs. The research findings were published in PLOS One.

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In sensitivity analysis, increasing the rate of availability of new drugs did not substantially alter the results. Lowering the toxicity of future ART drugs had greater potential to increase benefit for many patient groups, increasing QALE by as much as 10%.

If the toxicity of pipeline drugs is reduced compared with existing drugs (the pipeline drugs have a mortality relative risk of 1), the presence of new pipeline drugs can increase the quality-adjusted life expectancy by as much as 11% in young patients with high viral load, according to the investigators.

“The future availability of new ART drugs without lower toxicity raises optimal treatment initiation for most patients, and improves clinical outcomes, especially for younger patients with higher viral loads,” wrote the researchers.

“Reductions in toxicity of future ART drugs could impact optimal treatment initiation and improve clinical outcomes for all HIV patients.”


  1. Roberts M et al. Plos One. 2014; doi: 10.1371/journal.pone.0098354