Comparative Analysis of the Efficacy and Safety of HIV/AIDS Treatment Strategies: A Comprehensive Review of Clinical Trial Data

This comprehensive review and meta-analysis aimed to evaluate the comparative efficacy and safety of various antiretroviral (ARV) therapy regimens for HIV/AIDS treatment based on clinical trial data over 48 and 96 weeks. We conducted a systematic search across multiple databases, identifying 17 randomized controlled trials that met our inclusion criteria. These studies provided data on 12 different ARV regimens, focusing on integrase strand transfer inhibitor (INSTI)-based, non-nucleoside reverse transcriptase inhi- bitor (NNRTI)-based, and protease inhibitor (PI)-based treatments. Efficacy was measured by the percentage of participants achieving viral load suppression below 50 copies/mL, while safety was assessed through the incidence of serious adverse events. The analysis revealed significant variability in the efficacy and safety profiles of the ARV regimens studied. INSTI-based treatments, notably elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) and dolutegravir/lamivudine (DTG/3TC), demonstrated the highest levels of viral suppression, maintaining effectiveness at both the 48 and 96-week benchmarks. Notably, a weak positive correlation was identified between the efficacy of these treatments and the incidence of serious adverse events. Despite this correlation, the overall link between a regimen’s efficacy and its safety was found to be weak, highlighting the critical importance of tailoring HIV treatment to the individual patient’s needs and circumstances. The study underscores the importance of individualizing HIV/AIDS treatment strategies to optimize both efficacy and safety outcomes. While INSTI-based regimens show promise in terms of efficacy, the slightly increased risk of serious adverse events calls for careful consideration in treatment selection and monitoring. Future research should focus on longitudinal studies and the develop- ment of predictive models to further refine treatment strategies, helping ensure they are tailored to meet the individual needs of patients living with HIV/AIDS. Keywords HIV/AIDS, antiretroviral therapy, efficacy, safety, INSTI- based regimens