• Virologic efficacy, defined as HIV-1 viral load less than 200 copies/ml [ Time Frame: Through Week 24 ] [ Designated as safety issue: No ]
  
• Treatment-related toxicity of Grade 3 or higher as measured by development of drug-related toxicities severe enough to warrant dose modification, interruption, or permanent discontinuation [ Time Frame: Through Week 24 ] [ Designated as safety issue: Yes ]
  

• Virologic efficacy [ Time Frame: At Weeks 48 and 96 ] [ Designated as safety issue: No ]
  
• Treatment related toxicity [ Time Frame: At Weeks 48 and 96 ] [ Designated as safety issue: Yes ]
  
• Virologic failure, defined as HIV-1 viral load greater than 1,000 copies/ml [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• CD4 counts and HIV-1 RNA viral load [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• First new or recurrent AIDS-defining event (as defined by the CDC Expanded AIDS Surveillance Case definition) or death [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
  
• Treatment discontinuation, defined as premature discontinuation of participation in the study, failure to take ARV therapy for 8 or more consecutive weeks, or to switch to another ARV regimen for any reason during the full course of the study [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• Genotypic resistance measured by at least 1 genotypic mutation associated with resistance among subjects with a confirmed virologic failure (as described previously) and evaluation of genotypic drug resistance patterns [ Time Frame: At Weeks 24 and 96 ] [ Designated as safety issue: No ]
  
• Treatment adherence, defined by 95% or greater of prescribed pills taken [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• Quality of life as measured by items and patterns of responses to the FAHI questionnaire [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• HIV-1 DNA and RNA measurements [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  

Despite a relatively low prevalence of HIV infection, all HIV subtypes have been documented in Senegal. Data on mutations that confer resistance to antiretroviral (ARV) drugs are limited to HIV subtype B; adherence data are also limited. The study will evaluate the safety and efficacy of an ARV regimen given to treatment-naive HIV infected adults and adolescents. The study will also examine the characteristics of virologic failure and adherence in this treatment group. Participants will be recruited at two sites in Dakar, Senegal.

This study will last 96 weeks. At study entry, all participants will be given an ARV regimen of lamivudine/zidovudine twice daily and efavirenz once daily. If toxicity or treatment failure occurs, some participants may require changes in their ARV regimens. There will be 14 study visits during the study; a physical exam, blood collection, and sociodemographic and medication history assessments will occur at each visit. Participants will also be asked to complete quality-of-life and adherence questionnaires. An off-study visit will occur at approximately one month after Week 96, with assessments and procedures similar to visits during the study.