Modeling outcomes of first-line antiretroviral therapy and rate of CD4 counts change among a cohort of HIV/AIDS patients in Ethiopia: a retrospective cohort study
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2016
TITLE AUTHOR(S): T.Awoke, A.Worku, Y.Kebede, A.Kasim, B.Birlie, R.Braekers, K.Zuma, Z.Shkedy
KEYWORDS: ANTIRETROVIRAL THERAPY (ART), ETHIOPIA, HIV/AIDS
Print: HSRC Library: shelf number 9646
HANDLE: 20.500.11910/10792
URI: http://hdl.handle.net/20.500.11910/10792
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
Antiretroviral therapy has shown to be effective in reducing morbidity and mortality in patients infected with HIV for the past couples of decades. However, there remains a need to better understand the characteristics of long-term treatment outcomes in resource poor settings. The main aim of this study was to determine and compare the long-term response of patients on nevirapine and efavirenz based first line antiretroviral therapy regimen in Ethiopia. Hospital based retrospective cohort study was conducted from January 2009 to December 2013 at University hospital located in Northwest Ethiopia. Human subject research approval for this study was received from University of Gondar Research Ethics Committee and the medical director of the hospital. Cox-proportional hazards model was used to assess the effect of baseline covariates on composite outcome and a semi-parametric mixed effect model was used to investigate CD4 counts response to treatments. A total of 2386 HIV/AIDS naive patients were included in this study. Nearly one-in-four patients experienced the events, of which death, lost to follow up, treatment substitution and discontinuation of Non-Nucleoside Reverse Transcriptase Inhibitors(NNRTI) accounted: 99 (26.8%), 122 (33.0%), 137 (37.0%) and 12 (3.2%), respectively. The hazard of composite outcome on nevirapine compared with efavirenz was 1.02(95%CI: 0.52-1.99) with p-value = 0.96. Similarly, the hazard of composite outcome on tenofovir and stavudine compared with zidovudine were 1.87 (95%CI: 1.52-2.32), p-value < 0.0001 and 1.72(95% CI: 1.22-2.32), p-value = 0.002, respectively. The rate of CD4 increase in response to treatment was high during the first 10 months and stabilized later. This study revealed that treatment responses were comparable whether nevirapine or efavirenz was chosen to initiate antiretroviral therapy for HIV/AIDS patients in Ethiopia. There was significant difference on risk of composite outcome between patients who were initiated with Tenofovir containing ART regimen compared with zidovudine after controlling for NNRTI drug combinations.-
Related Research Outputs:
- An exploratory study of the impact of primary caregiver HIV infection on caregiving and child developmental outcome in the era of Haart: piloting the methodology
- Universal HIV testing of infants at immunization clinics: an acceptable and feasible approach for early infant diagnosis in high HIV prevalence settings
- Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa
- The phenomenology of bodily care: caregivers' experiences with AIDS patients before antiretroviral therapies in Lesotho
- Traditional complementary and alternative medicine and antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa
- Rifampin pharmacokinetics in children, with and without human immunodefiency virus infection, hospitalized for the management of severe forms of tuberculosis
- Utilisation of the national antiretroviral therapy guidelines among health care professionals working in Abuja treatment centres, Nigeria
- Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa
- Traditional complementary and alternative medicine and antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa
- Determinants of adherence to a single-dose nevirapine regimen for the Prevention of Mother-to-Child HIV Transmission in Gert Sibande district in South Africa
- Safer sexual behaviours after 1 year of antiretroviral treatment in KwaZulu-Natal, South Africa: a prospective cohort study
- The who & why of antiretroviral treatment adherence
- A decline in new HIV infections in South Africa: estimating HIV incidence from three national HIV surveys in 2002, 2005 and 2008
- Perceived stigma among patients receiving antiretroviral therapy: a prospective study in KwaZulu-Natal, South Africa
- Equity in the use of antiretroviral treatment in the public health care system in urban South Africa
- Factors associated with short-course antiretroviral prophylaxis (dual therapy) adherence for PMTCT in Nkangala district, South Africa
- Antiretrovirals and the use of traditional, complementary and alternative medicine by HIV patients in KwaZulu-Natal, South Africa: a longitudinal study
- Design and methods of a longitudinal study investigating the impact of antiretroviral treatment on the partnerships and sexual behaviour of HIV-infected individuals in rural KwaZulu-Natal, South Africa
- The influence of antiretroviral treatment on willingness to test: a qualitative study in rural KwaZulu-Natal, South Africa
- HIV sero-status disclosure and sexual behaviour among HIV positive patients who are on antiretroviral treatment (ART) in Mpumalanga, South Africa