|
|
|
|
|
Session 105
Poster Abstracts Response to Antiretroviral Therapy in Developing Countries Wednesday, 1:30 - 3:30 pm Hall A |
Background: In April 2004, the South African government embarked
on an ambitious antiretroviral (ARV) rollout in response to the HIV/AIDS
epidemic.
Methods: We undertook a retrospective medical file
review of all adult patients on ARV treatment during the first 10 weeks of a
public ARV clinic in
Results: Between April 2, 2004 and June 11, 2004, 352 adult patients
(age 17 or older) received ARV treatment. Women outnumbered men by a ratio of 2
to 1 and were significantly younger (average age of 35 and 40 years,
respectively). Patients were predominantly black (95%), and 41% of men and 27%
of women had a history of ARV treatment. In addition, 19% of women had a history
of exposure to nevirapine as to prevent
mother-to-child transmission, and 10% of patients were receiving treatment for
active TB at the time of enrollment in the program. The average CD4 count at
initiation of treatment in ARV treatment naïve patients was 100
cells/μL in women and 85 cells/μL in men. Almost all patients (92%) were started on
the first line regimen (stavudine [d4T]+lamivudine [3TC]+efavirenz [EFV]), even though one-third of patients had a
history of ARV treatment. The average weight gain in the first 6 weeks of
treatment was 1.5 kg. Regardless of side effects being recorded in 44% of
patients, only 10 patients (2.8%) required a change in ARV regimen by week 10
of the program; 16 (4.5%) patients were hospitalized, 11 (3.1%) experienced immune
reconstitution syndrome, 7 (2%) were lost to follow-up, and 5 (1.4%) died. One
woman became pregnant while taking EFV.
Conclusions:
Early data on drug toxicity, morbidity,
and loss to follow-up from the adult ARV treatment program in an ARV clinic in
Keywords: Africa; rollout; outcomes
 |