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Title: Immunovirological outcomes and resistance patterns at 4 years of antiretroviral therapy use in HIV-infected patients in Cambodia
Authors: Pujades-Rodríguez, Mar
Schramm, Birgit
Som, Leakena
Nerrienet, Eric
Narom, Prak
Chanchhaya, Ngeth
Ferradini, Laurent
Balkan, Suna
Affiliation: Epicentre, Paris, France; Medecins Sans Frontieres, Phnom Penh, Cambodia; HIV⁄Hepatitis Laboratory, Pasteur Institute, Phnom Penh, Cambodia; Khmero-Sovietic Friendship Hospital, Phnom Penh, Cambodia; Medecins Sans Frontieres, Paris, France
Citation: Trop Med Int Health 2011;16(2):205-13
Journal: Tropical Medicine & International Health : TM & IH
Issue Date: 1-Feb-2011
DOI: 10.1111/j.1365-3156.2010.02689.x
PubMed ID: 21087376
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Abstract: Objectives  To report immunovirological outcomes and resistance patterns in adults treated with triple combination antiretroviral therapy (cART) for 4 years in an HIV programme of Phnom Penh, Cambodia. Methods  It is a longitudinal study and cross-sectional evaluation of adults receiving cART for 4 years. CD4 cell counts and HIV-1 RNA were quantified, and resistance patterns were determined. Drug-related toxicity was assessed by clinicians and through laboratory testing. Results  After 4 years of cART start, the cumulative probability of retention in care was 0.80 and survival among patients not lost to follow-up was 0.85. A total of 349 patients (98% of eligible) participated in the cross-sectional evaluation. Ninety per cent were receiving first-line therapy, 29% stavudine- and 58% zidovudine-containing regimens (compared with 94% and 3% at cART initiation). Ninety-three per cent of patients were clinically asymptomatic, and severe lipodystrophy and dyslipidemia were diagnosed in 7.2% and 4.0%, respectively. Good treatment adherence was reported by 83% of patients. Median CD4 T-cell count was 410 cells/μl [IQR 290-511], and 90% of patients had >200 cells/μl. Only 15 (4%) patients had detectable HIV viral load (eight had <200 CD4 cells/μl), five had thymidine analogue mutations, and nine were resistant to two drug classes. In an intention-to-treat analysis, 26.1% (95% CI 22.0-30.5) of patients had failed first-line therapy. Conclusions  In this Cambodian cohort of adults who started cART at an advanced stage of HIV disease, we observed good clinical and immunovirological outcomes and self-reported treatment adherence at 4 years of therapy.
Type: Article
Language: en
Antiretroviral Therapy
Drug Resistance
Treatment Outcome
ISSN: 1365-3156
Rights: Archived on this site with the kind permission of Wiley-Blackwell,
Appears in topics: HIV/AIDS

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