Efavirenz or nevirapine in three-drug combination therapy with two nucleoside or nucleotide-reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral-naïve individuals.

Summary: For people starting HIV treatment for the first time, the "cocktail" of medication usually includes a choice between two main anchor drugs: Efavirenz or Nevirapine. A comprehensive review of 12 studies involving over 3,000 patients found that both drugs are equally good at suppressing the virus and keeping the immune system strong. The real difference lies in the side effects. Efavirenz is more likely to cause mental or nervous system issues, such as sleep disturbances or mood changes. In contrast, Nevirapine is harder on the body’s organs, showing a higher risk of liver problems and severe skin rashes. Ultimately, since both fight the virus equally well, the choice depends on which side effects a patient wants to avoid.