Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults

Bartlett, John A.; DeMasi, Ralph; Quinn, Joseph B.; Moxham, Christopher M.; Rousseau, Franck

doi:10.1097/00002030-200107270-00006

Cited by 339 publications

(239 citation statements)

References 15 publications

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“…Immunologic outcomes were good: the mean CD4+ Tcell count increase after one year was 236/mm 3 ; previous studies showed increases in mean CD4+ T-cell counts ranging from 127/mm 3 to 165/mm 3 [5,[8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…These results compare well to the results of HAART in other settings. A historical meta-analysis of clinical trials on NNRTI-based triple combination therapy in antiretroviral-naïve patients in western settings showed a plasma HIV-RNA level lower than 50 copies/ml after 48 weeks of treatment in 51% of patients (ITT) [5]. An on-treatment analysis in a recent study on HAART in subSahara Africa showed a plasma HIV-RNA level lower than 50 copies/ml in 61% of patients after 48 weeks of therapy (ITT 55%) [11].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa

Barth

Meer

Hoepelman

et al. 2008

Eur J Clin Microbiol Infect Dis

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The purpose of this study was to assess the oneyear efficacy of highly active antiretroviral therapy (HAART) administered by general practitioners in a primary care community clinic in rural South Africa. We performed an observational cohort study of 675 treatmentnaïve human immunodeficiency virus (HIV)-infected patients (including 66 children) who began HAART at least 12 months prior to the data analyses. Throughout treatment, the CD4+ T-cell count (percentage of CD4+ Tcells in children) and plasma HIV-RNA level were determined and the patient's weight was recorded. The primary outcome was mortality. Secondary outcomes were viral suppression, immunological response, and weight gain. One year after the start of HAART, 100 of the 675 (15%) patients were lost to follow-up and 119 patients (18%), including six children, died. Mortality was highest during the first few months of treatment. Based on an ontreatment analysis at one year after the start of therapy, 83% of adults and 71% of children had a viral load <400 copies/ ml; the viral load was <50 copies/ml in 70% of adults and 61% of children. At one year, the mean CD4+ T-cell count in adults had increased by 236/mm 3 , and the mean body mass index (BMI) had increased by 3.5 kg/m 2 . In children, the mean CD4% had increased by 17.6. A low Karnofsky score and a low baseline CD4+ T-cell count were independently associated with death. In addition to these factors, a low baseline BMI and gender were predictive of a poor immunological outcome. Our study shows that adequately monitored HIV/acquired immunodeficiency syndrome (AIDS) care administered by general practitioners and their staff is feasible and leads to good results in a rural, primary care center in sub-Saharan Africa. In order to achieve even better results, early mortality should be reduced and efforts should be made to start HAART earlier.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa

Barth

Meer

Hoepelman

et al. 2008

Eur J Clin Microbiol Infect Dis

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“…Inadequate or inconsistent medication intake is a concern for health care providers, who are aware of the side effects and lifestyle changes required for their patients to take these medications. Research shows that medication-taking difficulties can be due to medication-related factors such as pill burden, side effects, and complicated regimens (Bartlett et al 2001;Fogarty et al 2002;. As new generations of drugs become available, pharmaceutical companies are addressing these concerns by developing pills that include more than one drug and regimen schedules that offer once or twice per day dosing with fewer and smaller pills.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

et al. 2007

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Objective-The primary aim of this study was to test a psychosocial model of medication adherence among people taking antiretroviral medications. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectancy, stigma, depression, and spirituality), social (social support, difficult life circumstances), and provider (patient satisfaction and decision-making) variables. © Springer Science+Business Media, LLC 2007Correspondence to: Colleen DiIorio, cdiiori@sph.emory.edu. Design-The data for this analysis were obtained from the parent study, which was a randomized controlled trial (Get Busy Living) designed to evaluate an intervention to foster medication adherence. Factor analysis was used to develop the constructs for the model, and structural equation modeling was used to test the model. Only baseline data were used in this cross sectional analysis. NIH Public AccessMethods-Participants were recruited from a HIV/AIDS clinic in Atlanta, GA. Prior to group assignment, participants were asked to complete a questionnaire that included assessment of the study variables.Results-A total of 236 participants were included in the analysis. The mean age of the participants was 41 years; the majority were male, and most were African-American. In the final model, self-efficacy and depression demonstrated direct associations with adherence; whereas stigma, patient satisfaction, and social support were indirectly related to adherence through their association with either self-efficacy or depression.Conclusion-These findings provide evidence to reinforce the belief that medication-taking behaviors are affected by a complex set of interactions among psychosocial variables and provide direction for adherence interventions.

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“…HIV-1 PR contains a homodimeric C-2 symmetric structure and each monomer contributes one catalytic aspartic residue along with threonine and glycine residues which are flexible and a flap that favors the binding of substrate and inhibitors. The highly active antiretroviral therapy (HAART) and protease inhibitors (PIs) along with reverse-transcriptase inhibitors have resulted in the unprecedented success of HIV/AIDS chemotherapy [9][10][11][12]. However owing to the rapid emergence of drug-resistant HIV-1 variants and transmission of these resistant viral strains along with the adverse side effects of currently used HIV-1 PIs, are remain critical factors that limiting the clinical effectiveness of HAART [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Exploration of the structural requirements of HIV-protease inhibitors using pharmacophore, virtual screening and molecular docking approaches for lead identification

Islam

Pillay

2015

Journal of Molecular Graphics and Modelling

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Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults

Abstract: The results suggest that three drug regimens containing two NRTI with a PI, a NNRTI, or a third NRTI may provide comparable activity, and practical issues such as daily pill burden should be considered when choosing a treatment regimen.

Cited by 339 publications

References 15 publications

Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa

Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa

Adherence to Antiretroviral Medication Regimens: A Test of a Psychosocial Model

Exploration of the structural requirements of HIV-protease inhibitors using pharmacophore, virtual screening and molecular docking approaches for lead identification

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