Immunovirological outcomes and resistance patterns at 4 years of antiretroviral therapy use in HIV-infected patients in Cambodia

Hdl Handle:
http://hdl.handle.net/10144/120329
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
Journal:
Tropical Medicine & International Health : TM & IH
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.
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
Issue Date:
1-Feb-2011
URI:
http://hdl.handle.net/10144/120329
DOI:
10.1111/j.1365-3156.2010.02689.x
PubMed ID:
21087376
Additional Links:
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02689.x/abstract
Submitted date:
2011-01-21
Type:
Article
Language:
en
ISSN:
1365-3156
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorPujades-Rodríguez, Maren
dc.contributor.authorSchramm, Birgiten
dc.contributor.authorSom, Leakenaen
dc.contributor.authorNerrienet, Ericen
dc.contributor.authorNarom, Praken
dc.contributor.authorChanchhaya, Ngethen
dc.contributor.authorFerradini, Laurenten
dc.contributor.authorBalkan, Sunaen
dc.date.accessioned2011-01-25T16:37:52Z-
dc.date.available2011-01-25T16:37:52Z-
dc.date.issued2011-02-01-
dc.date.submitted2011-01-21-
dc.identifier.citationTrop Med Int Health 2011;16(2):205-13en
dc.identifier.issn1365-3156-
dc.identifier.pmid21087376-
dc.identifier.doi10.1111/j.1365-3156.2010.02689.x-
dc.identifier.urihttp://hdl.handle.net/10144/120329-
dc.description.abstractObjectives  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.en
dc.languageENG-
dc.language.isoenen
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2010.02689.x/abstracten
dc.rightsArchived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]en
dc.subject.meshHIV/AIDSen
dc.subject.meshAntiretroviral Therapyen
dc.subject.meshCambodiaen
dc.subject.meshDrug Resistanceen
dc.subject.meshTreatment Outcomeen
dc.titleImmunovirological outcomes and resistance patterns at 4 years of antiretroviral therapy use in HIV-infected patients in Cambodiaen
dc.typeArticleen
dc.contributor.departmentEpicentre, 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, Franceen
dc.identifier.journalTropical Medicine & International Health : TM & IHen
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