Abacavir and lamivudine combination.

Background: Fixed dose antiretroviral combinations (FDC) may improve therapy adherence with reduced pill burden. Abacavir and lamivudine are well-established nucleoside reverse-transcriptase inhibitors available as a once-daily FDC. Abacavir is currently considered an alternative treatment option in most established treatment guidelines based on associations with cardiovascular events and lesser efficacy in patients with higher baseline viremia.

Objective: To summarize rigorous clinical trial data and cohort studies that examine efficacy, safety and tolerability of the individual components and the FDC of abacavir-lamivudine.

Methods: Clinical trial data, post-marketing research findings and clinical cohort data were reviewed to assess the efficacy, safety and tolerability of the individual components and the FDC of abacavir-lamivudine along with recommendations from published clinical treatment guidelines.

Results/conclusion: The efficacy of abacavir-lamivudine is well documented in numerous clinical studies and treatment guidelines. The introduction of laboratory testing to identify patients at risk for hypersensitivity has decreased the incidence of these reactions. Recent findings suggest that abacavir is an alternative treatment agent with baseline HIV RNA > 100,000 copies/ml. Data related to cardiovascular events associated with abacavir are conflicting. Hepatic function should be monitored closely in HIV/HBV co-infected patients who discontinue lamivudine-containing products as severe acute exacerbations of HBV have been reported.