On the eve of World AIDS day, Cipla Ltd announced that the company was ready to supply its combinations tenofovir/ emtricitabine / efavirenz and tenofovir/ lamivudine /efavirenz with a dose of 400 mg of efavirenz as a first-line initial therapy for HIV infection.
Studies now support the use of efavirenz 400 mg as a substitute for efavirenz 600 mg in cases where there is no co-infection with tuberculosis. Efavirenz 600 mg is currently used in antiretroviral therapy (ART) and is highly effective. However, it is known to have significant side effects, which can be very distressing for those taking it for treatment of HIV infection. Efavirenz 400 mg, with the same efficacy, is much better tolerated. It is expected that this improved formulation will help improve patient adherence as well as significantly reduce the cost of treatment. In addition it will also significantly reduce the pill size.
According to UNAIDS, there are approximately 37 million worldwide people living with HIV of which around 15.8 million people are reported to be receiving ART. WHO recently announced that it recommended to make ART available to all HIV-infected patients as soon as they are tested positive. This strategy should dramatically decrease HIV transmission but will require large additional resources, as the cost of ART remains substantial in spite of price reductions by manufacturers.
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It is expected that new guidelines for HIV treatment will include this dose reduction to efavirenz 400 mg.