Immunovirological outcomes and resistance patterns at 4 years of antiretroviral therapy use in HIV-infected patients in Cambodia
AffiliationEpicentre, 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
MetadataShow full item record
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.
- Immunovirological and therapeutic follow-up of HIV-1/HIV-2-dually seropositive patients.
- Authors: Landman R, Damond F, Gerbe J, Brun-Vezinet F, Yeni P, Matheron S
- Issue date: 2009 Jan 28
- Study of the impact of HIV genotypic drug resistance testing on therapy efficacy.
- Authors: Van Vaerenbergh K
- Issue date: 2001
- Short communication: three years follow-up of first-line antiretroviral therapy in cambodia: negative impact of prior antiretroviral treatment.
- Authors: Ségéral O, Limsreng S, Nouhin J, Hak C, Ngin S, De Lavaissière M, Goujard C, Taburet AM, Nerrienet E, Delfraissy JF, Ouk V, Dulioust A
- Issue date: 2011 Jun
- HIV-1 resistant strains acquired at the time of primary infection massively fuel the cellular reservoir and persist for lengthy periods of time.
- Authors: Ghosn J, Pellegrin I, Goujard C, Deveau C, Viard JP, Galimand J, Harzic M, Tamalet C, Meyer L, Rouzioux C, Chaix ML, French PRIMO Cohort Study Group (ANRS CO 06).
- Issue date: 2006 Jan 9
- Long-term suppression of plasma viremia with highly active antiretroviral therapy despite virus evolution and very limited selection of drug-resistant genotypes.
- Authors: Pariente N, Pernas M, de la Rosa R, Gómez-Mariano G, Fernández G, Rubio A, López M, Benito JM, López-Galíndez C, Leal M, Domingo E, Martinez MA, Mas A
- Issue date: 2004 Jul