en
Scientific article
English

Generic fixed-dose combination antiretroviral treatment in resource-poor settings : multicentric observational cohort

Published inAIDS, vol. 20, no. 8, p. 1163-1169
Publication date2006-05-12
Abstract

Background: 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.

Objective: 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.

Methods: Survival was analysed using Kaplan-Meier method and factors associated with progression to death with Cox proportional hazard ratio.

Results: 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.

Conclusions: Positive outcomes for d4T/3TC/NVP are reported for up to 18 months in terms of efficacy and safety.

eng
Keywords
  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Antiretroviral Therapy, Highly Active / methods
  • CD4 Lymphocyte Count
  • Developing Countries
  • Drug Administration Schedule
  • Drugs, Generic / administration & dosage
  • Drugs, Generic / adverse effects
  • Drugs, Generic / therapeutic use
  • Epidemiologic Methods
  • Female
  • HIV Infections / drug therapy
  • Humans
  • Lamivudine / administration & dosage
  • Lamivudine / adverse effects
  • Lamivudine / therapeutic use
  • Male
  • Medically Underserved Area
  • Nevirapine / administration & dosage
  • Nevirapine / adverse effects
  • Nevirapine / therapeutic use
  • Reverse Transcriptase Inhibitors / administration & dosage
  • Reverse Transcriptase Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Stavudine / administration & dosage
  • Stavudine / adverse effects
  • Stavudine / therapeutic use
  • Treatment Outcome
Affiliation Not a UNIGE publication
Research group
Citation (ISO format)
CALMY, Alexandra et al. Generic fixed-dose combination antiretroviral treatment in resource-poor settings : multicentric observational cohort. In: AIDS, 2006, vol. 20, n° 8, p. 1163–1169. doi: 10.1097/01.aids.0000226957.79847.d6
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Article (Published version)
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Identifiers
ISSN of the journal0269-9370
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