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Three-Year Outcome Data of Second-Line Antiretroviral Therapy in Ugandan Adults: Good Virological Response but High Rate of Toxicity
* To whom correspondence should be addressed. E-mail: bcastelnuovo{at}idi.co.ug.
Objective. To evaluate the safety and virological response to lopinavir/ritonavir containing second-line therapy after failing a first line nonnucleoside reverse transcriptase inhibitor (NNRTI) based regimen. Design. Prospective 36 months cohort study of patients switched to zidovudine/stavudine plus didanosine plus lopinavir/ritonavir capsules as second-line regimen. Methodology. Structured interview, medical examination, and laboratory assessment performed every 6 months. Results. We enrolled 40 patients; 1 died and 3 were lost to follow-up. Median CD4+ count at baseline was 108 cell/µL, median log viral load was 4.8 copies/mL. Sixteen (40%) patients had baseline genotypic resistant test, 14 (87%) had lamivudine resistance mutations, and all had NNRTIs resistance mutations. At month 36, 82% of the patients achieved viral suppression (<400 copies/mL) and the median increase in CD4+ count was 214 cell/µL, (interquartile range: 128-295). Twenty-five patients (62%) experienced at least one adverse event. Conclusions. Our study confirms lopinavir/ritonavir-based second-line regimen but with a high rate of toxicities.
First published on December 17, 2008, doi:10.1177/1545109708328538 |
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