• Login
    View Item 
    •   Home
    • 1 Published Research and Commentary
    • HIV/AIDS
    • View Item
    •   Home
    • 1 Published Research and Commentary
    • HIV/AIDS
    • View Item
    Jan 16, 2021
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of MSFTitleAuthorsSubjectsPublisherJournalThis CollectionTitleAuthorsSubjectsPublisherJournal

    Stavudine- and nevirapine-related drug toxicity while on generic fixed-dose antiretroviral treatment: incidence, timing and risk factors in a three-year cohort in Kigali, Rwanda.

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    tox st and nev transactions.pdf
    Size:
    268.5Kb
    Format:
    PDF
    Download
    Authors
    van Griensven, J
    Zachariah, R
    Rasschaert, F
    Mugabo, J
    Atté, EF
    Reid, T
    Affiliation
    Médecins Sans Frontières, Operational Centre Brussels, Medical Department, Duprestraat 94, 1090 Brussels, Belgium.
    Issue Date
    2009-09-02
    
    Metadata
    Show full item record
    Journal
    Transactions of the Royal Society of Tropical Medicine and Hygiene
    Abstract
    This cohort study was conducted to report on the incidence, timing and risk factors for stavudine (d4T)- and nevirapine (NVP)-related severe drug toxicity (requiring substitution) with a generic fixed-dose combination under program conditions in Kigali, Rwanda. Probability of 'time to first toxicity-related drug substitution' was estimated using the Kaplan-Meier method and Cox-proportional hazards modeling was used to identify risk factors. Out of 2190 adults (median follow-up: 1.5 years), d4T was replaced in 175 patients (8.0%) for neuropathy, 69 (3.1%) for lactic acidosis and 157 (7.2%) for lipoatrophy, which was the most frequent toxicity by 3 years of antiretroviral treatment (ART). NVP was substituted in 4.9 and 1.3% of patients for skin rash and hepatotoxicity, respectively. Use of d4T 40mg was associated with increased risk of lipoatrophy and early (<6 months) neuropathy. Significant risk factors associated with lactic acidosis and late neuropathy included higher baseline body weight. Older age and advanced HIV disease increased the risk of neuropathy. Elevated baseline liver tests and older age were identified as risk factors for NVP-related hepatotoxicity. d4T is associated with significant long-term toxicity. d4T-dose reduction, increased access to safer ART in low-income countries and close monitoring for those at risk are all relevant strategies.
    URI
    http://hdl.handle.net/10144/85133
    DOI
    10.1016/j.trstmh.2009.07.009
    PubMed ID
    19732926
    Language
    en
    ISSN
    1878-3503
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.trstmh.2009.07.009
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

    Related articles

    • Generic fixed-dose combination antiretroviral treatment in resource-poor settings: multicentric observational cohort.
    • Authors: Calmy A, Pinoges L, Szumilin E, Zachariah R, Ford N, Ferradini L, Médecins Sans Frontieres.
    • Issue date: 2006 May 12
    • Incidence of treatment-limiting toxicity with stavudine-based antiretroviral therapy in Cambodia: a retrospective cohort study.
    • Authors: Phan V, Thai S, Choun K, Lynen L, van Griensven J
    • Issue date: 2012
    • High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda.
    • Authors: van Griensven J, De Naeyer L, Mushi T, Ubarijoro S, Gashumba D, Gazille C, Zachariah R
    • Issue date: 2007 Aug
    • Safety and efficacy of a simplified fixed-dose combination of stavudine, lamivudine and nevirapine (GPO-VIR) for the treatment of advanced HIV-infected patients: a 24-week study.
    • Authors: Anekthananon T, Ratanasuwan W, Techasathit W, Sonjai A, Suwanagool S
    • Issue date: 2004 Jul
    • Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda.
    • Authors: van Griensven J, Zachariah R, Mugabo J, Reid T
    • Issue date: 2010 Dec
    DSpace software (copyright © 2002 - 2021)  DuraSpace
    Quick Guide | Contact Us
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.