Safety and efficacy of a generic fixed-dose combination of stavudine, lamivudine and nevirapine antiretroviral therapy between HIV-infected patients with baseline CD4 <50 versus CD4 ≥ 50 cells/mm³

• Main Authors: Likanonsakul Sirirat, Chimsuntorn Sukanya, Manosuthi Weerawat, Sungkanuparph Somnuek
• Format: Article
• Language: English
• Published: BMC 2007-03-01
• Series: AIDS Research and Therapy
• Online Access: http://www.aidsrestherapy.com/content/4/1/6

<p>Abstract</p> <p>Background</p> <p>Antiretroviral therapy (ART) with a generic fixed-dose combination (FDC) of stavudine (d4T)/lamivudine (3TC)/nevirapine (NVP) is widely used in developing countries. The clinical data of this FDC among very advanced HIV-infected patients is limited.</p> <p>Methods</p> <p>A retrospective cohort study was conducted among ART-naïve HIV-infected patients who were initiated a generic FDC of d4T/3TC/NVP between May 2004 and October 2005. Patients were categorized into 2 groups according to the baseline CD4 (group A: <50 cell/mm³and group B: ≥ 50 cell/mm³).</p> <p>Results</p> <p>There were 204 patients with a mean ± SD age of 37.1 ± 8.9 years, 120 (58.8%) in group A and 84 (41.2%) in group B. Median (IQR) CD4 cell count was 6 (16–29) cells/mm³in group A and 139 (92–198) cells/mm³in group B. Intention-to-treat analysis at 48 weeks, 71.7% (86/120) of group A and 75.0% (63/84) of group B achieved plasma HIV RNA <50 copies/ml (<it>P </it>= 0.633). On-treatment analysis, 90.5% (87/96) in group A and 96.9% (63/65) in group B achieved plasma HIV RNA <50 copies/ml (<it>P </it>= 0.206). At 12, 24, 36 and 48 weeks of ART, mean CD4 were 98, 142, 176 and 201 cells/mm³in group A and 247, 301, 336 and 367 cells/mm³in group B, respectively. There were no differences of probabilities to achieve HIV RNA <50 copies/ml (<it>P </it>= 0.947) and CD4 increment at 48 weeks between the two groups (<it>P </it>= 0.870). Seven (9.6%) patients in group A and 4 (8.5%) patients in group B developed skin reactions grade II or III (<it>P </it>= 1.000). ALT at 12 weeks was not different from that at baseline in both groups (<it>P </it>> 0.05).</p> <p>Conclusion</p> <p>Initiation of FDC of d4T/3TC/NVP in HIV-infected patients with CD4 <50 and ≥ 50 cells/mm³has no different outcomes in terms of safety and efficacy. FDC of d4T/3TC/NVP can be effectively used in advance HIV-infected patients with CD4 <50 cells/mm³.</p>