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BMJ 2009; 338 doi: (Published 03 June 2009) Cite this as: BMJ 2009;338:b2172

A US clinical trial in virologically stable HIV positive patients on combination retroviral therapy (ART) has tested a simplified treatment regimen comprising a once daily single pill of efavirenz, tenofovir disoproxil fumarate, and emtricitabine. Just as many patients who switched to the simplified treatment maintained viral suppression as those who continued on ART, indicating that the simplified regimen is not inferior to continued treatment with ART (Journal of Acquired Immune Deficiency Syndromes 2009;51:163-74, doi:10.1097/QAI.0b013e3181a572cf). Discontinuation rates were similar in the two treatment groups, and patients mainly dropped out owing to adverse effects. Those patients who switched to the simplified regimen preferred the single pill, reporting enhanced quality of life. The authors caution that anyone who switches should be watched carefully for evidence of virological rebound.

Small bowel contractility is thought to be more prominent in obese people, enhancing both nutrient absorption and hunger stimulation. An in vitro study looking for objective evidence of such observations in small bowel samples from obese and non-obese patients found that human small bowel contractility was increased in tissue from obese patients (Annals of Surgical Innovation and Research 2009;3:4, doi:10.1186/1750-1164-3-4). This finding suggests that obese …

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