Still on First Line Regimen

I asked Dr. Ditangco if I'm still on the first line regimen and she said yes. I asked her this because it's really confusing. She added that the second line regimen is an addition of the protease inhibitor in the regimen. She mentioned that we have no third line regimen here in the country.

I researched about this from the WHO guidelines (sorry terms are maybe confusing):

"WHO continues to recommend that the first-line regimen for adults and adolescents contain two 
NRTIs plus one NNRTI. This recommendation is based on available evidence, clinical 
experience and programmatic feasibility for the wider introduction of ART in resource-limited 
settings. Regimens based on combination of two NRTIs plus one NNRTI are efficacious, 
are generally less expensive than other regimens, have generic formulations, are often available 
as FDCs and do not require a cold chain. In addition, they preserve a potent new class (protease 
inhibitors) for second-line treatments. Disadvantages include different drug half-lives which 
complicate ART stopping procedures, the fact that a single mutation is associated with resistance 
to some drugs (3TC and the NNRTIs), and cross-resistance within the NNRTI class. 
The thiacytadine analogues (3TC or FTC) are pivotal to first-line regimens. 3TC or FTC should be 
used with a companion nucleoside or nucleotide analogue, the choices here being AZT, TDF, 
ABC or d4T. 


The preferred NRTI backbone is composed of AZT or TDF combined with either 3TC or FTC. Didanosine (ddI) is an adenosine analogue NRTI recommended to be reserved for secondline regimens (see Section 10.2). Finally an NNRTI, either EFV or NVP, should be added.1
WHO recommends that countries purchase and stock a higher proportion of the preferred NRTI 
and NNRTI and a smaller amount of the drug that will be used in case of toxicity and/or 
contraindication of the first choice. This means procuring two NRTIs and two NNRTIs in addition 
to 3TC/FTC. For example, TDF can be a substitute for AZT in patients with severe AZT-induced 
anaemia, and EFV can be a substitute for NVP in cases of NVP-associated hepatotoxicity.


A triple NRTI regimen should be considered as an alternative for first-line ART in situations where 
NNRTI options provide additional complications and to preserve the PI class for second- line 
treatment  [C-I] (e.g. in women with CD4 counts of 250−350 cells/mm3; coinfection with viral 
hepatitis or tuberculosis; severe adverse reactions to NVP or EFV, infection with HIV-2). 
Recommended triple NRTI combinations are zidovudine + lamivudine + abacavir  [A-I] and 
zidovudine + lamivudine + tenofovir."


In the country, 2 of these NRTI's (Nucleoside Reverse Transcriptase Inhibitors) are part of the regimen:
     -zidovudine
     -lamivudine
     -tenofovir
     -stavudine
     -emtricitabine
     -abacavir

They are mixed with 1 of these NNRTI's (Non-Nucleoside Reverse Transcriptase Inhibitors to form the first line regimen:
     -nevirapine
     -efavirenz
     -etravirine
     -rilpivirine
     -delavirdine

So what am I taking now? I'm taking tenofovir and lamivudine (2 NRTI's) and Efavirenz (an NNRTI). I'm still on the first line regimen then!

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