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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Initial response to highly active antiretroviral therapy in HIV-1C-infected adults in a public sector treatment program in Botswana
Journal of Acquired Immune Deficiency Syndromes, Volume 40, No. 3, Year 2005
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Description
Objective: To describe the response to highly active antiretroviral treatment (HAART) in a public sector pilot antiretroviral (ARV) treatment program in Botswana. Methods: The response to HAART is described in adult HIV-infected ARV-naive patients initiating treatment from April 2001 to January 2002 at Princess Marina Hospital in Gaborone, Botswana. Patients had medical and laboratory evaluations before initiating ARV treatment and were followed longitudinally. For analysis, data were collected from charts and patient management records. Results: One hundred fifty-three ARV-naive patients initiated HAART Most received didanosine plus stavudine (ddl + d4T) with efavirenz or nevirapine. The mean CD4+ cell count increase was 149 cells/mm3 at 24 weeks and 204 cells/mm3 at 48 weeks. The percentage of patients with an HIV-1 RNA level ≤400 copies/mL was 87.0% at 24 weeks and 78.8% at 48 weeks. The Kaplan-Meier 1-year survival estimate was 84.7% (79.0%, 90.8%), with a 3.2-fold increased risk (P = 0.004) of mortality among patients with a CD4+ cell count <50 cells/mm3. The 1-year Kaplan-Meier estimate of toxicity-related drug switches was 32.2% (20.3%, 40.4%). The most common toxicity was peripheral neuropathy, occurring more frequently in patients with a preexisting diagnosis of peripheral neuropathy and among those placed on ddl + d4T-containing regimens. Conclusions: An excellent response to HAART was observed among HIV-1C-infected patients, paralleling those seen elsewhere. Despite excellent responses, high rates of toxicity were observed for ddI + d4T-containing regimens. Copyright © 2005 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Wester, Carolyn William
Unknown Affiliation
Kim, Soyeon
Unknown Affiliation
Bussmann, Hermann
Unknown Affiliation
Avalos, Ava
Unknown Affiliation
Peter, Trevor F.
Unknown Affiliation
Gaolathe, Tendani
Unknown Affiliation
Mujugira, Andrew
Unknown Affiliation
Busang, Lesego
Unknown Affiliation
Vanderwarker, Chris
Unknown Affiliation
Cardiello, Peter
Unknown Affiliation
Johnson, Onalethata
Unknown Affiliation
Thior, Ibou
Unknown Affiliation
Mazonde, Patson
Unknown Affiliation
Moffat, Howard J.
Unknown Affiliation
Essex, Max E.
Unknown Affiliation
Marlink, Richard G.
Unknown Affiliation
Statistics
Citations: 134
Authors: 16
Affiliations: 7
Identifiers
Doi:
10.1097/01.qai.0000159668.80207.5b
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
Botswana