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January 13, 1999

Nevirapine, Didanosine, and Zidovudine for Patients With HIV: The INCAS Trial—Reply

Author Affiliations

Margaret A.WinklerMDIndividualAuthorPhil B.FontanarosaMD, Senior EditorsIndividualAuthor

JAMA. 1999;281(2):130-131. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-2-jac80019

In Reply: As noted by Dr Clay and associates, the results of the INCAS trial have been used to establish guidelines. We agree that it is unfortunate when guidelines must be based on preliminary reports, but we also agree with the experts and applaud their efforts to use the most current information available.

The end-of-trial results for the INCAS trial were reported in several different ways, which may have led to some confusion. First, simple descriptive presentation focused on the final visit at 52 weeks and noted that 51% of patients receiving the combination of nevirapine, zidovudine, and didanosine had undetectable levels of HIV. Second, to use a more stringent standard in defining durable viral suppression, we also reported patients with undetectable viral load at all available visits between 40 and 52 weeks. The majority of patients had 3 or 4 observations in the interval, and several patients "failed" based on a single value, not necessarily their week 52 value, with detectable virus. In short, there are no contradictions in the information reported.