***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND We report data from NEWART , a r and omised phase 4 clinical trial comparing virologic efficacy and safety of nevirapine ( NVP ) vs. ritonavir-boosted atazanavir ( ATV/r ) on a background of tenofovir/emtricitabine ( TDF/FTC ) in HIV-1-infected treatment-naïve patients . This study enrolled patients according to CD4-based initiation criteria for NVP ( < 250 cells/mm(3 ) for women and < 400 cells/mm(3 ) for men ) , to reduce the likelihood of symptomatic hepatic events . NEWART was design ed to support and confirm results from ARTEN , an international trial with similar design and study endpoints . METHODS A total of 152 patients were r and omised 1 : 1 to open-label  NVP 200 mg twice daily or ATV/r ( 300/100 mg ) once daily , plus once daily TDF/FTC ( 300/200 mg ) . All participants met CD4(+ ) guidelines at entry . The primary endpoint for non-inferiority was virologic response prior to and at week 48 ( confirmed HIV plasma viral load < 50 copies/ml , without rebound or change in ARVs ) . Safety data , including plasma lipids , were recorded throughout the study . RESULTS The primary endpoint was achieved in 46/75 ( 61.3 % ) and 50/77 ( 64.9 % ) of patients taking NVP and ATV/r , respectively . Frequency of adverse events ( AEs ) was similar between arms , with 88.0 % of NVP-treated patients and 94.8 % of ATV/r-treated patients experiencing at least one AE . Nine patients ( 12 % ) in each arm experienced an AE that led to discontinuation . At week 48 , a significantly greater increase was seen in mean plasma HDL cholesterol ( HDL-C ) in the NVP arm ( 9.6 mg/dl ) vs. the ATV/r arm ( 3.5 mg/dl ) ; p = 0.016 . Also , total cholesterol (TC):HDL-C ratio on-treatment was -0.38 and -0.02 for the NVP and ATV/r arms , respectively ( p = 0.038 ) . CONCLUSIONS Efficacy results were consistent with the ARTEN study demonstrating that NVP was non-inferior to ATV/r when taken in combination with TDF/FTC . Rates of AEs were similar between the two arms , whereas HDL-C increased and TC : HDL-C decreased significantly more in patients taking NVP than ATV/r In a r and omized control trial , Shahin Lockman and colleagues compare nevirapine-based therapy with lopinavir/ritonavir-based therapy for HIV-infected women without previous exposure to antiretroviral treatment Objective : To compare regimens consisting of either efavirenz or nevirapine and two or more nucleoside reverse transcriptase inhibitors ( NRTIs ) among HIV-infected , antiretroviral-naive , and AIDS-free individuals with respect to clinical , immunologic , and virologic outcomes . Design : Prospect i ve studies of HIV-infected individuals in Europe and the US included in the HIV-CAUSAL Collaboration . Methods : Antiretroviral therapy-naive and AIDS-free individuals were followed from the time they started an NRTI , efavirenz or nevirapine , classified as following one or both types of regimens at baseline , and censored when they started an ineligible drug or at 6 months if their regimen was not yet complete . We estimated the ‘ intention-to-treat ’ effect for nevirapine versus efavirenz regimens on clinical , immunologic , and virologic outcomes . Our models included baseline covariates and adjusted for potential bias introduced by censoring via inverse probability weighting . Results : A total of 15 336 individuals initiated an efavirenz regimen ( 274 deaths , 774 AIDS-defining illnesses ) and 8129 individuals initiated a nevirapine regimen ( 203 deaths , 441 AIDS-defining illnesses ) . The intention-to-treat hazard ratios [ 95 % confidence interval ( CI ) ] for nevirapine versus efavirenz regimens were 1.59 ( 1.27 , 1.98 ) for death and 1.28 ( 1.09 , 1.50 ) for AIDS-defining illness . Individuals on nevirapine regimens experienced a smaller 12-month increase in CD4 cell count by 11.49 cells/&mgr;l and were 52 % more likely to have virologic failure at 12 months as those on efavirenz regimens . Conclusions : Our intention-to-treat estimates are consistent with a lower mortality , a lower incidence of AIDS-defining illness , a larger 12-month increase in CD4 cell count , and a smaller risk of virologic failure at 12 months for efavirenz compared with nevirapine Abstract PURPOSE : A r and omized , open-label , pilot study was undertaken to explore the antiviral activity and tolerability of two nonnucleoside reverse transcriptase inhibitors ( NNRTIs ) , nevirapine ( NVP ) and efavirenz ( EFV ) . METHOD : HIV-infected antiretroviral-naive adults with CD4 counts > 100 cells/mm3 and detectable plasma HIV RNA below 100,000 copies/mL were r and omized to receive didanosine ( ddI ) and stavudine ( d4 T ) plus either NVP or EFV . Assessment s were made every 12 weeks . Primary endpoints were the proportion of patients reaching plasma HIV RNA < 50 copies/mL and /or developing NNRTI-related toxicities leading to drug discontinuation . Baseline characteristics were comparable for participants in the EFV ( n = 31 ) and NVP arms ( n = 36 ) . RESULTS : At 48 weeks , 23/31 ( 74 % ) patients in the EFV group and 23/36 ( 64 % ) in the NVP group had < 50 HIV RNA copies/mL ( intention-to-treat analysis ) . Adverse events led to NNRTI discontinuation in 4 and 3 patients in the EFV and NVP arms , respectively . There were no statistically significant differences between groups regarding any primary endpoint . NVP and EFV along with two NRTIs may be equally well tolerated and effective at achieving < 50 HIV RNA copies/mL in naive patients with CD4 counts > 100 cells/mm3 and HIV RNA < 105 copies/mL. CONCLUSION : A much larger study is needed to demonstrate any significant differences between NVP and EFV , if they exist at all OBJECTIVE Our objective was to compare immunologic effectiveness of nevirapine and efavirenz based antiretroviral therapy in antiretroviral naïve HIV-1 infected Indian patients . DESIGN AND METHODS Study was an observational , non-r and omized , longitudinal cohort . Antiretroviral naive HIV-1 infected patients receiving efavirenz + 2NRTI ( n=254 ) and nevirapine + 2 NRTI ( n=857 ) from April 2000 were followed up at two tertiary care HIV clinics at Ahmedabad and Pune . Patients were followed up clinical ly monthly and CD4 was carried out every 3 monthly . All patients were examined for various side effects as well as development of various OIs . Data were analyzed using st and ard statistical methods . RESULTS Baseline characteristics for both the groups ( NVP and EFV ) were comparable . In the r and om effects model , there was an increase of 40.97 ( p < 0.05 ) units of CD4 cell counts with an unit increase in time in the NVP arm as against a 44.75 ( p < 0.05 ) units of increase in CD4 cell counts in the EFV group with a unit increase in time , which is significant for both groups . However , at any given point of time there was no difference in the rate of increase of CD4 count between the two treatment arms ( p = 0.58 ) . Hypersensitivity reaction ( 6.6 % in NVP vs. 2.32 % in EFV , p = 0.0146 ) and hepatitis ( 3.2 % in NVP vs. 0 % in EFV , p = 0.0085 ) were more common with nevirapine , while neurologic disturbances ( 0.93 % in NVP vs. 20.15 % in EFV , p = 0.0001 ) were more common with efavirenz . Incidence of distal sensory neuropathy and lipid abnormalities was similar in both the groups . CONCLUSION Use of NVP and EFV based HAART in antiretroviral naive Indian patients led to significant and durable rise in CD4 cell count . Although observational and non-r and omized , our study showed equivalent immunological response amongst NVP and EFV based HAART which is in line with the results of the 2NN study Abstract Background : To improve the dosing frequency and pill burden of antiretroviral therapy , we compared two once-daily dosed regimens to a twice-daily dosed regimen . Method : HIV-1-infected , antiretroviral drug-naïve adults were r and omized to either twice-daily nelfinavir and stavudine and once-daily didanosine ( regimen A ) or simplified once-daily dosed antiretroviral regimens consisting of nevirapine , didanosine , and lamivudine ( regimen B ) or saquinavir , ritonavir , didanosine , and lamivudine ( regimen C ) . Results : At 48 weeks of therapy , the proportion of patients with a blood plasma HIV-1 RNA concentration ( pVL ) < 50 copies/mL by intention-totreat analysis was 42.3 % , 50.0 % , and 56.5 % for regimens A ( n = 26 ) , B ( n = 22 ) , and C ( n = 23 ) , respectively . The time to a pVL < 50 copies/mL for the first time was significantly shorter in regimen C , and there was significantly more progression to CDC events in regimen B. These differences are possibly due to differences in baseline characteristics . Adverse events were lowest for regimen C ; more signs associated with mitochondrial toxicity occurred in regimen A. Increase in CD4 count was comparable between arms . Conclusion : No statistically significant difference in efficacy was found between the two investigated once-daily dosed treatment regimens ( B and C ) and the reference ( A ) . Regimen C possibly had a better virological response and less toxicity than regimens A and Background : National initiatives offering non-nucleoside reverse transcriptase inhibitor (NNRTI)-based combination antiretroviral therapy ( cART ) have exp and ed in sub-Saharan Africa . The Tshepo study is the first clinical trial evaluating the long-term efficacy and tolerability of efavirenz versus nevirapine-based cART  among adults in Botswana . Methods : A 3-year r and omized study ( n = 650 ) using a 3 × 2 × 2 factorial design comparing efficacy and tolerability among : ( i ) zidovudine/lamivudine versus zidovudine/didanosine versus stavudine/lamivudine ; ( ii ) efavirenz versus nevirapine ; and ( iii ) community-based supervision versus st and ard adherence strategies . This paper focuses on comparison ( ii ) . Results : There was no significant difference by assigned NNRTI in time to virological failure with resistance ( log-rank P = 0.14 ) , nevirapine versus efavirenz [ risk ratio ( RR ) 1.54 , 95 % CI 0.86–2.70 ] . Rates of virological failure with resistance were 9.6 % nevirapine-treated ( 95 % CI 6.8–13.5 ) versus 6.6 % efavirenz-treated ( 95 % CI 4.2–10.0 ) at 3 years . Women receiving nevirapine-based cART trended towards higher virological failure rates when compared with efavirenz-treated women , Holm-corrected ( log-rank P = 0.072 ) , nevirapine versus efavirenz ( RR 2.22 , 95 % CI 0.94–5.00 ) . A total of 139 patients  had 176 treatment-modifying toxicities , with a shorter time to event in nevirapine-treated versus efavirenz-treated patients ( RR 1.85 , 1.20–2.86 ; log-rank P = 0.0002 ) . Conclusion : Tshepo-treated patients had excellent overall immunological and virological outcomes , and no significant differences were observed by r and omized NNRTI comparison . Nevirapine-treated women trended towards higher virological failure with resistance compared with efavirenz-treated women . Nevirapine-treated adults had higher treatment modifying toxicity rates when compared with those receiving efavirenz . Nevirapine-based cART can continue to be offered to women in sub-Saharan Africa if patient education concerning toxicity is emphasized , routine safety monitoring chemistries are performed and the potential risk of efavirenz-related teratogenicity is 
    Output:
    
Results of the meta- analysis have shown that nevirapine , efavirenz , and ritonavir-boosted protease inhibitor , added to the background regimens , were equally effective in terms of reaching undetectable plasma HIV RNA level as well as risk of disease progression or death .
Despite limited RCTs data available for particular comparisons , our results suggest that nevirapine-based regimens may be considered for first-line treatment of HIV-infected adults , due to their comparable efficacy to the other currently recommended initial antiretroviral therapies