Generic Fixed-Dose Combination Antiretroviral Treatment in Resource-Poor Settings: Multicentric Observational Cohort
Affiliation
MSF, Campaign for Access to Essential Medicines, 78 rue de Lausanne, 1205 Geneva, Switzerland. acalmy@stvincents.com.auIssue Date
2006-05-12
Metadata
Show full item recordJournal
AIDS (London, England)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.PubMed ID
16691068Language
enISSN
0269-9370ae974a485f413a2113503eed53cd6c53
10.1097/01.aids.0000226957.79847.d6
Scopus Count
Collections
Related articles
- Field assessment of generic antiretroviral drugs: a prospective cohort study in Cameroon.
- Authors: Bourgeois A, Laurent C, Mougnutou R, Nkoué N, Lactuock B, Ciaffi L, Liégeois F, Andrieux-Meyer I, Zekeng L, Calmy A, Mpoudi-Ngolé E, Delaporte E
- Issue date: 2005
- Efficacy and safety of generic fixed-dose combination of stavudine, lamivudine and nevirapine (GPO-vir) in advanced HIV infection.
- Authors: Getahun A, Tansuphasawadikul S, Desakorn V, Dhitavat J, Pitisuttithum P
- Issue date: 2006 Sep
- Performance of a World Health Organization first-line regimen (stavudine/lamivudine/nevirapine) in antiretroviral-naïve individuals in a Western setting.
- Authors: Tam LW, Hogg RS, Yip B, Montaner JS, Harrigan PR, Brumme CJ
- Issue date: 2007 Jul
- Second-line antiretroviral therapy in resource-limited settings: the experience of Médecins Sans Frontières.
- Authors: Pujades-Rodríguez M, O'Brien D, Humblet P, Calmy A
- Issue date: 2008 Jul 11
- A prospective, 96-week study of the impact of Trizivir, Combivir/nelfinavir, and lamivudine/stavudine/nelfinavir on lipids, metabolic parameters and efficacy in antiretroviral-naive patients: effect of sex and ethnicity.
- Authors: Kumar PN, Rodriguez-French A, Thompson MA, Tashima KT, Averitt D, Wannamaker PG, Williams VC, Shaefer MS, Pakes GE, Pappa KA, ESS40002 Study Team.
- Issue date: 2006 Mar