Generic fixed-dose combination antiretroviral treatment in resource-poor settings: multicentric observational cohort
Copyright policy )Generic fixed-dose combination antiretroviral treatment in resource-poor settings: multicentric observational cohort
The use fixed-dose combination (FDC) is a critical tool in improving HAART. Studies on the effectiveness of combined lamivudine, stavudine and nevirapine (3TC/d4T/NVP) are scarce.To analyse 6861 patients in a large observational cohort from 21 Médecins Sans Frontieres (MSF) HIV/AIDS programmes taking 3TC/d4T/NVP, with subcohort analyses of patients at 12 and 18 months of treatment.Survival was analysed using Kaplan-Meier method and factors associated with progression to death with Cox proportional hazard ratio.Median baseline CD4 cell count at initiating of FDC was 89 cells/microl [interquartile range (IQR), 33-158]. The median follow-up time was 4.1 months (IQR, 1.9-7.3). The incidence rate of death during follow-up was 14.2/100 person-years [95% confidence interval (CI), 13.8-14.5]. Estimates of survival (excluding those lost to follow-up) were 0.93 (95% CI, 92-94) at 6 months (n = 2,231) and 0.90 (95% CI, 89-91) at 12 months (n = 472). Using a Cox model, the following factors were associated with death: male gender, symptomatic infection, body mass index < 18 kg/m and CD4 cell count 15-50 cells/microl or < 15 cells/microl. Subcohort analysis of 655 patients after 1 year of follow-up (M12 FDC cohort) revealed that 77% remained on HAART, 91% of these still on the FDC regimen; 5% discontinued the FDC because of drug intolerance. At 18 months, 77% of the patients remained on HAART.Positive outcomes for d4T/3TC/NVP are reported for up to 18 months in terms of efficacy and safety.
Anti-HIV Agents / therapeutic use, Adult, Male, Lamivudine / therapeutic use, Anti-HIV Agents, Lamivudine / adverse effects, Medically Underserved Area, Stavudine / therapeutic use, HIV Infections, Antiretroviral Therapy, Highly Active / methods, Drug Administration Schedule, Drugs, Generic / administration & dosage, Nevirapine / therapeutic use, Antiretroviral Therapy, Highly Active, Reverse Transcriptase Inhibitors / adverse effects, Antiretroviral Therapy, Highly Active / adverse effects, Drugs, Generic, Humans, Nevirapine, Stavudine / administration & dosage, Nevirapine / adverse effects, Developing Countries, Reverse Transcriptase Inhibitors / therapeutic use, HIV Infections / drug therapy, Lamivudine / administration & dosage, CD4 Lymphocyte Count, Reverse Transcriptase Inhibitors / administration & dosage, Drugs, Generic / therapeutic use, Stavudine, Treatment Outcome, Drugs, Generic / adverse effects, Nevirapine / administration & dosage, Lamivudine, Stavudine / adverse effects, Reverse Transcriptase Inhibitors, Female, Epidemiologic Methods, Anti-HIV Agents / adverse effects, Anti-HIV Agents / administration & dosage
Anti-HIV Agents / therapeutic use, Adult, Male, Lamivudine / therapeutic use, Anti-HIV Agents, Lamivudine / adverse effects, Medically Underserved Area, Stavudine / therapeutic use, HIV Infections, Antiretroviral Therapy, Highly Active / methods, Drug Administration Schedule, Drugs, Generic / administration & dosage, Nevirapine / therapeutic use, Antiretroviral Therapy, Highly Active, Reverse Transcriptase Inhibitors / adverse effects, Antiretroviral Therapy, Highly Active / adverse effects, Drugs, Generic, Humans, Nevirapine, Stavudine / administration & dosage, Nevirapine / adverse effects, Developing Countries, Reverse Transcriptase Inhibitors / therapeutic use, HIV Infections / drug therapy, Lamivudine / administration & dosage, CD4 Lymphocyte Count, Reverse Transcriptase Inhibitors / administration & dosage, Drugs, Generic / therapeutic use, Stavudine, Treatment Outcome, Drugs, Generic / adverse effects, Nevirapine / administration & dosage, Lamivudine, Stavudine / adverse effects, Reverse Transcriptase Inhibitors, Female, Epidemiologic Methods, Anti-HIV Agents / adverse effects, Anti-HIV Agents / administration & dosage
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