Management of HIV-1 Infection With a Combination of Nevirapine, Stavudine, and Lamivudine

Idigbe, Emmanuel O.; Adewole, T A; Eisen, Geoffrey; Kanki, Phyllis; Odunukwe, N N; Onwujekwe, D; Audu, Rosemary; Araoyinbo, Idowu; Onyewuche, J; Salu, Olumuyiwa B.; Adedoyin, J.; Musa, Adesola Z.

doi:10.1097/01.qai.0000159516.39982.1b

Cited by 53 publications

(50 citation statements)

References 19 publications

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“…These findings were similar to those of studies [6,7] conducted in resourcelimited settings. Adherence, injecting drug use, and baseline pVL were associated with time to viral load suppression in multivariate analysis; these observations have also been previously reported [6,[8][9][10][11][12][13]. These data indicate that this regimen should be expected to lead to successful virological suppression in most settings, and, if this is not the case, it may indicate serious flaws with the implementation of antiviral programmes.…”

Section: Discussionsupporting

confidence: 82%

Performance of a World Health Organization first‐line regimen (stavudine/lamivudine/nevirapine) in antiretroviral‐naïve individuals in a Western setting

Tam

Hogg²,

Yip³

et al. 2007

HIV Medicine

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ObjectivesIn 2003, the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) introduced the '3 by 5 Initiative' to treat 3 million individuals by the end of 2005. This study evaluates the time to treatment termination, viral load suppression, and detection of drug resistance among antiretroviral-naïve individuals initiating stavudine/lamivudine/nevirapine (d4T/3TC/NVP) in British Columbia, Canada, to provide a context for future programme planning. MethodsPrimary outcome was time to treatment termination. Secondary outcome was time to viral suppression. Accumulation of drug resistance mutations was followed systematically in the first 145 individuals over 30 months. Cox proportional hazard regression identified factors associated with termination and suppression. 3), 132 (42.3%) patients switched treatment, 53 (17.0%) stopped therapy and 26 (8.3%) died. Of 308 subjects with baseline viral load 4500 copies/mL, 223 (72.4%) suppressed to 500 copies/mL at a median of 2.0 months. Among 145 (46.5%) individuals followed longitudinally, resistance mutations to NNRTI, 3TC, or other NRTI were detected in 11 (7.6%), six (4.1%) and four (2.8%) individuals after 12 months of therapy; and in 23 (15.9%), 17 (12.0%), and six (4.1%) individuals after 30 months. ConclusionsThe population requiring second-line treatment was 30% at 12 months and 40% at 24 months; 20% had detectable drug resistance mutations by 30 months. While these results are from a Western setting, they illustrate the need to consider second-and third-line approaches as antiretroviral treatment scale-up continues in the developing world.Keywords: antiretroviral therapy, cohort studies, drug resistance, epidemiology, World Health Organization . The WHO plan recommended regimens consisting of lamivudine (3TC) with stavudine (d4T) or zidovudine (ZDV), and either nevirapine (NVP) or efavirenz (EFV) [2]. As a result of the availability of a simple fixed dose combination, the d4T/3TC/NVP regimen has become widely used. However, limited data are available regarding the use of this regimen in resource-limited settings.In order to provide a context for programme planning where access to technologies such as viral load and drug Methods BC Centre for Excellence in HIV/AIDS Drug Treatment ProgrammeIn the province of BC, antiretrovirals are distributed free of charge to HIV-1-infected individuals through a centralized HIV/AIDS drug treatment programme where a complete prospective profile of therapy use is maintained. Antiretrovirals are prescribed according to specific guidelines set by the British Columbia Therapeutic Guidelines Committee which are largely consistent with international guidelines [3]. Study populationAll HIV-1-positive, antiretroviral-naïve adults who initiated HAART with d4T/3TC/NVP in BC between 1 August 1996 and 30 September 2003 were eligible for inclusion in the study. Our analysis was restricted to individuals who had baseline CD4 and plasma viral load (pVL) data available within 6 months prior to the start of treat...

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Section: Discussionsupporting

confidence: 82%

Performance of a World Health Organization first‐line regimen (stavudine/lamivudine/nevirapine) in antiretroviral‐naïve individuals in a Western setting

Tam

Hogg²,

Yip³

et al. 2007

HIV Medicine

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“…Numerous studies have demonstrated high levels of adherence among persons receiving ART in resource-limited areas [14,[22][23][24][25], including among African cohorts. A recent systematic overview found that 77% of sub-Saharan Africans maintained 100% adherence with ART, compared with 55% of North Americans [8].Therefore, the ADAR study results regarding adherence in a Tanzanian population are consistent with observations from other cohorts in resource-limited areas.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Incomplete Adherence, Virologic Failure, and Antiviral Drug Resistance among HIV-Infected Adults Receiving Antiretroviral Therapy in Tanzania

Ramadhani

Thielman²,

Landman³

et al. 2007

Clinical Infectious Diseases

161

169

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“…Substantial rates of decline in the number of opportunistic infections and in the prevalence of AIDS-related mortality have been observed [12,13]. A number of studies have reported reductions in the level of plasma HIV-1 RNA and increases in the number of the CD4 cell count, even among PLWHA with very low initial CD4 counts [14][15][16][17][18]. Antiretroviral drugs must be taken as a lifelong therapy and their success relies on continual adherence to the medication regimen.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes regarding HIV/AIDS and antiretroviral therapy among patients at a Nigerian treatment clinic

Olowookere

Fatiregun

Adewole

2012

J Infect Dev Ctries

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Introduction: We assessed the knowledge of and attitudes toward HIV/AIDS and antiretroviral therapy (ART) in people living with HIV/AIDS (PLWHA). Methodology: A descriptive, cross-sectional study design was employed. A structured interviewer-administered questionnaire was administered to consecutive, consenting PLWHA who had been receiving treatment for a minimum of three months. The level of ART adherence was calculated manually for each respondent. Results: In total 318 PLWHA completed the questionnaire. The mean and median time on ART was 17.8 months and 19 months respectively. The mean age of the respondents was 39.1±9.6 years. The majority of these respondents (76.9%) had completed secondary education. Over 80% of the respondents reported knowing that HIV can be transmitted through blood transfusions and unprotected sexual intercourse. Seventy-six per cent of the respondents reported knowing that ART suppresses HIV activity. However, 33% of the respondents denied being HIV positive, while 22.6% reported that they felt that taking ART was shameful. Over 32% of the respondents reported that good adherence to ART would raise suspicions about their HIV status, and 66.7% had not yet disclosed their HIV status to anyone. Most (77.7%) respondents had good knowledge of HIV/AIDS while 75.2% had good knowledge of ART. Also 78.9% had positive attitude to HIV/AIDS while 73.9%) had positive attitude to ART. Respondents with good knowledge about HIV/AIDS and a positive attitude about the disease tended to be more adherent to ART (p<0.01). Conclusions: The majority of respondents had good knowledge of and a positive attitude toward HIV/AIDS and ART adherence.

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Management of HIV-1 Infection With a Combination of Nevirapine, Stavudine, and Lamivudine

Cited by 53 publications

References 19 publications

Performance of a World Health Organization first‐line regimen (stavudine/lamivudine/nevirapine) in antiretroviral‐naïve individuals in a Western setting

Performance of a World Health Organization first‐line regimen (stavudine/lamivudine/nevirapine) in antiretroviral‐naïve individuals in a Western setting

Predictors of Incomplete Adherence, Virologic Failure, and Antiviral Drug Resistance among HIV-Infected Adults Receiving Antiretroviral Therapy in Tanzania

Knowledge and attitudes regarding HIV/AIDS and antiretroviral therapy among patients at a Nigerian treatment clinic

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