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Abstract
THE NIGERIAN ACCELERATED ANTIRETROVIRAL DRUG INITIATIVE- EVALUATION OF COMBINATION OF NEVIRAPINE (NVP), LAMIVUDINE (3TC), AND STAVUDINE (D4T) IN ANTIRETROVIRAL NAIVE PATIENTS
E. Ekong1, O. Akinlade2, A. Uwah3, I. Grant-Isibor4
168 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria, 2Military Hospital, Awolowo Road, Ikoyi, Lagos, Nigeria, 3Central Public Health Laboratory, Yaba, Lagos, Nigeria, 4Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
Background:The Federal government of Nigeria in March 2002 commenced an accelerated pilot antiretroviral (ARV) drug initiative targeting 10,000 adults and 5,000 children with generic forms of NVP, 3TC, and d4T at $350.00/patient/year. Patients pay only $120/year.
Objective:To evaluate clinical and immunological benefits of combination of dual NRTIs (3TC,d4T) and one NNRTI (NVP) at weeks 12, 24, and 36.
Methods:Open label, prospective study, between March and December 2002 in three centres. Drugs were in generic forms. Recruitment was done from outpatient, inpatient clinics and HIV/AIDS communities. Evaluation including general well being, weight, full blood count and differentials, CD4+ cell count, total lymphocyte count, LFTs, biochemistry, adverse effects, tolerance, and compliance was four-weekly.
Results:Total number of 74 patients, 48 males, median age 34 years (range 19-68). Baseline median weight was 51.7 kg (range 46-76), CD4+ 214.3 cells/ml (range 101-295) and PCV was 32% (range 26-42), 15 patients (20.8%) had TB, 13 skin rashes, six oropharyngeal candidiasis, two genital warts, and three HBV. One patient died in week one from TB. At week 12, mean weight was 55.7 kg (range 47.5-78), mean CD4+ was 298.3 cells/ml (range 115.2-530), and mean PCV was 37.4 % (range 30-45), six patients reached undetectable viral load, and five patients were lost to follow-up. At week 24, the mean weight was 63.6 kg (range 47-80), CD4 348.5 cells/ml (range 175-557.5), and PCV 38.3 (range (30-45). At week 36, mean weight was 62.7 kg. Most common adverse effects were peripheral neuropathy and rash.
Conclusion: Combination of NVP, 3TC, and d4T is potent, and well tolerated in our setting. Main constraints were irregular monitoring due to cost. Scaling-up and long-term follow-up is on. Resistance studies are necessary to guide in the next choice of antiretroviral drugs for the country.
The 2nd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
629
Suggested Citation
" E. Ekong , et al.
THE NIGERIAN ACCELERATED ANTIRETROVIRAL DRUG INITIATIVE- EVALUATION OF COMBINATION OF NEVIRAPINE (NVP), LAMIVUDINE (3TC), AND STAVUDINE (D4T) IN ANTIRETROVIRAL NAIVE PATIENTS.
Poster:
The 2nd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
629"
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