Antiretroviral treatment changes in adults from Cote d'Ivoire: the roles of tuberculosis and pregnancy
Antiretroviral treatment changes in adults from Cote d'Ivoire: the roles of tuberculosis and pregnancy
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DOI：
10.1097/qad.0b013e32832ec1c3
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发表时间：
2010-01-02
期刊：
影响因子：
3.8
通讯作者：
Seyler, Catherine
中科院分区：
文献类型：
--
作者：
Messou, Eugene;Anglaret, Xavier;Seyler, Catherine
目的：为了确定艾滋病毒感染的成年人在Cote d 'Ivoire.Methods的第一次抗逆转录病毒治疗的变化率和原因：我们评估成人谁开始在阿比让的门诊抗逆转录病毒治疗。我们记录了基线和随访数据，包括药物处方和改变替代一线方案（药物替代任何原因，但失败）或二线方案（开关失败）的原因。结果：2012年艾滋病毒感染的成年人（73%，妇女）开始抗逆转录病毒治疗。在基线时，9%的患者正在接受结核病治疗，3%的妇女怀孕。一线抗逆转录病毒治疗包括两种核苷逆转录酶抑制剂（58%司他夫定-拉米夫定，42%齐多夫定-拉米夫定）和依法韦仑（63%），奈韦拉平（32%）或茚地那韦（5%）。中位随访时间为16.9个月。在此期间，205例（10%）患者死亡，261例（13%）失访。总体而言，治疗调整率为20.7/100患者-年。最常见的修改是不耐受（12.4/100患者-年）、妊娠（4.5/100患者-年）和结核病（2.5/100患者-年）的药物替代。司他夫定、奈韦拉平、齐多夫定和依法韦仑的不耐受相关替代率分别为17.9/100患者年、6.3/100患者年、3.9/100患者年和0.1/100患者年。20%的efavirenz替换导致怀孕和18%的nevirapine替换与tuberculosis treatment.Conclusion：在抗逆转录病毒治疗开始后的第一个月，三分之一的治疗变化发生的原因以外的不耐受的药物或治疗失败。在非洲，毒品预测对于确保艾滋病毒治疗方案的成功至关重要。在撒哈拉以南非洲，应更方便地提供在怀孕或结核病治疗期间不需要中断的药物，作为一线药物。(C)2010年Wolters Kluwer Health竖条Lippincott威廉姆斯&威尔金斯
Objective: To determine the rates and causes of first antiretroviral treatment changes in HIV-infected adults in Cote d'Ivoire.Methods: We evaluated adults who initiated antiretroviral treatment in an outpatient clinic in Abidjan. We recorded baseline and follow-up data, including drug prescriptions and reasons for changing to alternative first-line regimens (drug substitution for any reason but failure) or second-line regimens (switch for failure).Results: Two thousand and twelve HIV-infected adults (73%, women) initiated antiretroviral treatment. At baseline, 9% of all patients were on treatment for tuberculosis and 3% of women were pregnant. First-line antiretroviral treatment consisted of two nucleoside reverse transcriptase inhibitors (58% stavudine-lamivudine, 42%, zidovudine-lamivudine) and efavirenz (63%), nevirapine (32%) or indinavir (5%). Median follow-up time was 16.9 months. During this time, 205 (10%) patients died and 261 (13%) were lost to follow-up. Overall, the rate of treatment modifications was 20.7/100 patient-years. The most common modifications were drug substitutions for intolerance (12.4/100 patient-years), pregnancy (4.5/100 patient-years) and tuberculosis (2.5/100 patient-years). The rates of intolerance-related substitutions were 17.9/100 patient-years for stavudine, 6.3/100 patient-years for nevirapine, 3.9/100 patient-years for zidovudine and 0.1/100 patient-years for efavirenz. Twenty percent of efavirenz substitutions resulted from pregnancy and 18% of nevirapine Substitutions were related to tuberculosis treatment.Conclusion: During the first months following antiretroviral treatment initiation, a third of all treatment changes occurred for reasons other than intolerance to the drug or treatment failure. in Africa, drug forecasting is crucial to ensuring the success of HIV treatment programmes. Drugs that do not require interruptions during pregnancy or tuberculosis treatment should be made more readily available as first-line drugs in sub-Saharan Africa. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins