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Experience with the use of a first-line regimen of stavudine, lamivudine and nevirapine in patients in the TREAT Asia HIV Observational Database

  1. J Zhou1,
  2. NI Paton2,
  3. R Ditangco3,
  4. Y-MA Chen4,
  5. A Kamarulzaman5,
  6. N Kumarasamy6,
  7. CKC Lee7,
  8. PCK Li8,
  9. TP Merati9,
  10. P Phanuphak10,
  11. S Pujari11,
  12. A Vibhagool12,
  13. F Zhang13,
  14. J Chuah14,
  15. KR Frost15,
  16. DA Cooper1,
  17. MG Law1,
  18. on behalf of the TREAT Asia HIV Observational Database1

Article first published online: 15 JAN 2007

DOI: 10.1111/j.1468-1293.2007.00417.x

Issue

HIV Medicine

HIV Medicine

Volume 8, Issue 1, pages 8–16, January 2007

Additional Information

How to Cite

Zhou, J., Paton, N., Ditangco, R., Chen, Y.-M., Kamarulzaman, A., Kumarasamy, N., Lee, C., Li, P., Merati, T., Phanuphak, P., Pujari, S., Vibhagool, A., Zhang, F., Chuah, J., Frost, K., Cooper, D., Law, M. and on behalf of the TREAT Asia HIV Observational Database (2007), Experience with the use of a first-line regimen of stavudine, lamivudine and nevirapine in patients in the TREAT Asia HIV Observational Database. HIV Medicine, 8: 8–16. doi: 10.1111/j.1468-1293.2007.00417.x

Author Information

  1. 1

    National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia,

  2. 2

    Tan Tock Seng Hospital, Singapore,

  3. 3

    Research Institute for Tropical Medicine, Manila, Philippines,

  4. 4

    AIDS Prevention and Research Centre, National Yang-Ming University, Taipei, Taiwan,

  5. 5

    University of Malaya, Kuala Lumpur, Malaysia,

  6. 6

    YRG Centre for AIDS Research and Education, Chennai, India,

  7. 7

    Hospital Kuala Lumpur, Kuala Lumpur, Malaysia,

  8. 8

    Queen Elizabeth Hospital, Hong Kong, China,

  9. 9

    School of Medicine, Udayana University & Sanglah Hospital, Denpasar, Bali, Indonesia,

  10. 10

    HIV-NAT/The Thai Red Cross AIDS Research Centre, Bangkok, Thailand,

  11. 11

    HIV Project, Ruby Hall Clinic, Pune, India,

  12. 12

    Ramathibodi Hospital, Bangkok, Thailand,

  13. 13

    Beijing Ditan Hospital, Beijing, China,

  14. 14

    Gold Coast Sexual Health Clinic, Miami, Qld, Australia,

  15. 15

    American Foundation for AIDS Research, New York, NY, USA

* Mr Jialun Zhou, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia. Tel: + 612 93850900; fax: +612 93850920; e-mail: jzhou@nchecr.unsw.edu.au

Publication History

  1. Issue published online: 15 JAN 2007
  2. Article first published online: 15 JAN 2007
  3. Received: 11 October 2005, accepted 10 March 2006

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Keywords:

  • adverse effects;
  • antiretroviral treatment;
  • Asia-Pacific region;
  • stavudine/lamivudine/nevirapine;
  • treatment change

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.

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