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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Implementing a tenofovir-based first-line regimen in rural lesotho: Clinical outcomes and toxicities after two years
Journal of Acquired Immune Deficiency Syndromes, Volume 56, No. 3, Year 2011
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Description
Background: The latest World Health Organization guidelines recommend replacing stavudine with tenofovir or zidovudine in first-line antiretroviral therapy in resource-limited settings. We report on outcomes and toxicities among patients on these different regimens in a routine treatment cohort in Lesotho. Methods: All adult patients initiating antiretroviral therapy from January 1, 2008, to December 31, 2008, were included in the analysis and followed until December 31, 2009. Choice of regimen was determined by clinical criteria. Results: Of 1124 patient records analyzed, median age was 39 years, and the majority (67.7%) were women. Five hundred eighty-seven patients were started on tenofovir, 255 on zidovudine, and 282 on stavudine. Patients on zidovudine were more than twice as likely to experience a toxicity-driven regimen substitution compared with tenofovir (adjusted hazard ratio: 2.32, 95% confidence interval: 1.23 to 4.40); for patients on stavudine, the risk of a toxicity-driven regimen switch was almost 6 times higher than tenofovir (adjusted hazard ratio: 5.43, 95% confidence interval: 3.31 to 8.91). Conclusions: Our findings support the latest World Health Organization Guidelines, in particular the adoption of tenofovir in first line, given the advantages in terms of tolerability and availability as a once-daily formulation. Copyright © 2011 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Bygrave, Helen
Unknown Affiliation
Ford, Nathan P.
Unknown Affiliation
Cutsem, Gilles Van
Unknown Affiliation
Hilderbrand, Katherine
Unknown Affiliation
Jouquet, Guillaume
Unknown Affiliation
Goemaere, Eric
Unknown Affiliation
Vlahakis, Natalie
Unknown Affiliation
Triviño, Laura
Unknown Affiliation
Makakole, Lipontso
Unknown Affiliation
Kranzer, Katharina A.
Unknown Affiliation
Statistics
Citations: 50
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/QAI.0b013e3182097505
ISSN:
15254135
Research Areas
Environmental
Health System And Policy
Study Design
Cohort Study
Study Locations
Lesotho
Participants Gender
Female