BACKGROUND: The antiretroviral treatment (ART) combination of stavudine, lamivudine and nevirapine (d4T/3TC/NVP) is the most frequently used initial regimen in many Asian countries. There are few data on the outcome of this treatment in clinic cohorts in this region. METHODS: We selected patients from the TREAT Asia HIV Observational Database (TAHOD) who started their first ART regimen with d4T/3TC/NVP. Treatment change was defined as cessation of therapy or the addition or change of one or more drugs. Clinical failure was defined as diagnosis with an AIDS-defining illness, or death while on d4T/3TC/NVP treatment. RESULTS: The rate of treatment change among TAHOD patients starting d4T/3TC/NVP as their first antiretroviral treatment was 22.3 per 100 person-years, with lower baseline haemoglobin (i.e. anaemia) associated with slower rate of treatment change. The rate of clinical failure while on d4T/3TC/NVP treatment was 7.3 per 100 person-years, with baseline CD4 cell count significantly associated with clinical failure. After d4T/3TC/NVP was stopped, nearly 40% of patients did not restart any treatment and, of those who changed to other treatment, the majority changed to zidovudine (ZDV)/3TC/NVP and less than 3% of patients changed to a protease inhibitor (PI)-containing regimen. The rates of disease progression on the second-line regimen were similar to those on the first-line regimen. CONCLUSION: These real-life data provide an insight into clinical practice in Asia and the Pacific region. d4T/3TC/NVP is maintained longer than other first-line regimens and change is mainly as a result of adverse effects rather than clinical failure. There is a need to develop affordable second-line antiretroviral treatment options for patients with HIV infection in developing countries.
BACKGROUND: The antiretroviral treatment (ART) combination of stavudine, lamivudine and nevirapine (d4T/3TC/NVP) is the most frequently used initial regimen in many Asian countries. There are few data on the outcome of this treatment in clinic cohorts in this region. METHODS: We selected patients from the TREAT Asia HIV Observational Database (TAHOD) who started their first ART regimen with d4T/3TC/NVP. Treatment change was defined as cessation of therapy or the addition or change of one or more drugs. Clinical failure was defined as diagnosis with an AIDS-defining illness, or death while on d4T/3TC/NVP treatment. RESULTS: The rate of treatment change among TAHOD patients starting d4T/3TC/NVP as their first antiretroviral treatment was 22.3 per 100 person-years, with lower baseline haemoglobin (i.e. anaemia) associated with slower rate of treatment change. The rate of clinical failure while on d4T/3TC/NVP treatment was 7.3 per 100 person-years, with baseline CD4 cell count significantly associated with clinical failure. After d4T/3TC/NVP was stopped, nearly 40% of patients did not restart any treatment and, of those who changed to other treatment, the majority changed to zidovudine (ZDV)/3TC/NVP and less than 3% of patients changed to a protease inhibitor (PI)-containing regimen. The rates of disease progression on the second-line regimen were similar to those on the first-line regimen. CONCLUSION: These real-life data provide an insight into clinical practice in Asia and the Pacific region. d4T/3TC/NVP is maintained longer than other first-line regimens and change is mainly as a result of adverse effects rather than clinical failure. There is a need to develop affordable second-line antiretroviral treatment options for patients with HIV infection in developing countries.
Authors: Somnuek Sungkanuparph; Rebecca Oyomopito; Sunee Sirivichayakul; Thira Sirisanthana; Patrick C K Li; Pacharee Kantipong; Christopher K C Lee; Adeeba Kamarulzaman; Liesl Messerschmidt; Matthew G Law; Praphan Phanuphak Journal: Clin Infect Dis Date: 2011-04-15 Impact factor: 9.079
Authors: Sang Hoon Han; Jialun Zhou; Suneeta Saghayam; Sasheela Vanar; Nittaya Phanuphak; Yi-Ming A Chen; Thira Sirisanthana; Somnuek Sungkanuparph; Christopher K C Lee; Sanjay Pujari; Patrick C K Li; Shinichi Oka; Vonthanak Saphonn; Fujie Zhang; Tuti Parwati Merati; Matthew G Law; Jun Yong Choi Journal: Endocr J Date: 2011-04-27 Impact factor: 2.349
Authors: J Zhou; P C K Li; N Kumarasamy; M Boyd; Y M A Chen; T Sirisanthana; S Sungkanuparph; S Oka; G Tau; P Phanuphak; V Saphonn; F J Zhang; S F S Omar; C K C Lee; R Ditangco; T P Merati; P L Lim; J Y Choi; M G Law; S Pujari Journal: HIV Med Date: 2009-07-06 Impact factor: 3.180
Authors: Preeyaporn Srasuebkul; Poh Lian Lim; Man Po Lee; Nagalingeswaran Kumarasamy; Jialun Zhou; Thira Sirisanthana; Patrick C K Li; Adeeba Kamarulzaman; Shinichi Oka; Praphan Phanuphak; Saphonn Vonthanak; Tuti P Merati; Yi-Ming A Chen; Somnuek Sungkanuparph; Goa Tau; Fujie Zhang; Christopher K C Lee; Rossana Ditangco; Sanjay Pujari; Jun Y Choi; Jeffery Smith; Matthew G Law Journal: Clin Infect Dis Date: 2009-04-01 Impact factor: 9.079
Authors: Andrew F Auld; Francisco Mbofana; Ray W Shiraishi; Mauro Sanchez; Charity Alfredo; Lisa J Nelson; Tedd Ellerbrock Journal: PLoS One Date: 2011-04-04 Impact factor: 3.240
Authors: Jialun Zhou; Antoine Jaquet; Emmanuel Bissagnene; Beverly Musick; Kara Wools-Kaloustian; Nicola Maxwell; Andrew Boulle; Firas Wehbe; Daniel Masys; Jeniffer Iriondo-Perez; Jay Hemingway-Foday; Matthew Law Journal: J Int AIDS Soc Date: 2012-01-30 Impact factor: 5.396