Efavirenz 5 days per week

The BREATHER study was a non-inferiority trial of efavirenz based antiretroviral treatment 5 days a week compared to daily treatment in children, adolescents and young adults. After 48 weeks the 5 days therapy was shown to be non-inferior to daily therapy. The study has been extended to 148 weeks with maintaining the original randomization. Also after 148 weeks the short treatment cycle was non inferior to daily therapy.

Turkova et al. PLOS one 2018;published 23 Apr: https://doi.org/10.1371/journal.pone.0196239

Comment: The idea of having the weekend off from medication may be appealing but it has not become widely used and updated guidelines recommending integrase inhibitors as first line therapy makes it unlikely that efavirenz 5 days a week will become an alternative.