Meta-analysis of Two Randomized Controlled Trials Comparing Combined Zidovudine and Didanosine Therapy With Combined Zidovudine, Didanosine, and Nevirapine Therapy in Patients With HIV

Abstract
To extend the range of CD4 counts in which a plasma viral load nadir (pVL) 100,000 copies/ml. Among triple therapy patients, the relative risk of virologic failure was higher for patients with higher baseline pVL (rate ratio [RR] = 2.51/log10 copies/ ml; p = .01), after controlling for compliance and pVL nadir. The relative risks of virologic failure associated with pVL nadir 400 copies/ml. We have extended our earlier results that achieving a pVL nadir <20 copies/ml is important for maintaining virologic suppression. In particular, we have demonstrated that a pVL nadir <20 copies/ml is at least fivefold more protective against virologic failure than achieving a pVL nadir between 20 and 400 copies/ml. Baseline pVL is significantly associated with the probability of achieving and sustaining virologic suppression.