Studies have documented that combination therapy with 2 or 3 drugs is better than AZT alone. Potent combinations would include a protease inhibitor plus 2 reverse transcriptase inhibitors. Such triple combinations have demonstrated the largest reductions in HIV viral load levels. The current recommendation for triple therapy is for those patients at higher risk for HIV progression, including those with HIV symptoms, those with low or rapidly falling CD4 counts and those with high HIV viral loads. The only monotherapy for HIV treatment endorsed by the committee was ddI, although studies have since demonstrated greater reductions in viral load using combinations that include ddI. Doctors have had the most experience with 2-drug combinations from the class of nucleoside analog reverse transcriptase inhibitors.
Every drug has potential side effects or toxicities.
Some of these overlap for different drugs. Many side effects or toxicities are minor or treatable. When the toxicities or side effects outweigh the benefits of a treatment, the treatment should be changed. Strict adherence to dosing schedules is important to avoid developing drug resistance, especially to protease inhibitors. The current drug regimen is not optimal.