Three-Year Outcome Data of Second-Line Antiretroviral Therapy in Ugandan Adults: Good Virological Response but High Rate of Toxicity

Castelnuovo, Barbara; Liu, John; Lutwama, Fred; Ronald, Allan; Spacek, Lisa A.; Bates, Michael; Kamya, Moses R.; Colebunders, Robert

doi:10.1177/1545109708328538

Cited by 27 publications

(37 citation statements)

References 14 publications

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“…In Africa and most resource-limited economics, the incidence of ADRs and toxicities have been shown to be responsible for frequent changes in first-line antiretroviral therapy (ART), and/or to the few available second-line regimens [4,5]. The first-line ART consist of the generic, fixed-dose combination (FDC) regimen of stavudine (d4T) or zidovudine (AZT) plus lamivudine (3TC) and nevirapine (NVP) or efavirenz (EFV) [6], although tenofovir disoproxilfumarate (TDF) plus 3TC or emtricitabine (FTC) and NVP or EFV combination regimens can be found in some settings [7].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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mentioning

confidence: 99%

“…The first-line ART consist of the generic, fixed-dose combination (FDC) regimen of stavudine (d4T) or zidovudine (AZT) plus lamivudine (3TC) and nevirapine (NVP) or efavirenz (EFV) [6], although tenofovir disoproxilfumarate (TDF) plus 3TC or emtricitabine (FTC) and NVP or EFV combination regimens can be found in some settings [7]. The second-line ART comprises the protease inhibitors [ritonavir-boosted lopinavir (LPV/r)] plus TDF/FTC plus either AZT, d4T, or didanosine (ddl) [4,7].Within the past decade, the World Health Organization (WHO) made ARV-associated ADRs the focus of many studies in patient safety and quality control, with the recognition that prevention of potential ADRs is a key element of efforts to improve patient care. This was sequel to increasing reports of ADRs and toxicities associated with the use of the first-line regimens from both developing and the developed countries [5,[8][9][10][11].…”

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Adverse Reactions Associated with Antiretroviral Regimens in Adult Patients of a University Teaching Hospital HIV Program in Zaria, Northern Nigeria: An Observational Cohort Study

Reginald¹,

Haruna²,

Sani³

et al. 2012

J Antivir Antiretrovir

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BackgroundHighly active antiretroviral therapy (HAART) has reduced the morbidity associated with HIV infection, and prolonged the lifespan of HIV/AIDS patients [1,2], but reports of morbidity and mortality from adverse reactions (ADRs) associated with the antiretroviral (ARV) drugs have tended to reduce these benefits [3][4][5]. In Africa and most resource-limited economics, the incidence of ADRs and toxicities have been shown to be responsible for frequent changes in first-line antiretroviral therapy (ART), and/or to the few available second-line regimens [4,5]. The first-line ART consist of the generic, fixed-dose combination (FDC) regimen of stavudine (d4T) or zidovudine (AZT) plus lamivudine (3TC) and nevirapine (NVP) or efavirenz (EFV) [6], although tenofovir disoproxilfumarate (TDF) plus 3TC or emtricitabine (FTC) and NVP or EFV combination regimens can be found in some settings [7]. The second-line ART comprises the protease inhibitors [ritonavir-boosted lopinavir (LPV/r)] plus TDF/FTC plus either AZT, d4T, or didanosine (ddl) [4,7].Within the past decade, the World Health Organization (WHO) made ARV-associated ADRs the focus of many studies in patient safety and quality control, with the recognition that prevention of potential ADRs is a key element of efforts to improve patient care. This was sequel to increasing reports of ADRs and toxicities associated with the use of the first-line regimens from both developing and the developed countries [5,[8][9][10][11]. These reports led to the revision of ART guidelines which recommended, among other things, the reduction of the dose of d4T from 40mg to 30mg for all patients, irrespective of body weight; the substitution of d4T with AZT or TDF in the presence of d4T toxicity, and of NVP with EFV in females and males with baseline CD4+ cell counts above 250 /µl and 400 /µl respectively [12][13][14][15].Because ADRs may be influenced by many factors, it is necessary to monitor patients on ART by keeping accurate information on their morbidity. Such information can be helpful as a guide to the AbstractBackground: Highly active antiretroviral therapy (HAART) has reduced the morbidity associated with HIV infection, and prolonged the lifespan of HIV/AIDS patients, but reports of adverse reactions associated with the antiretroviral drugs exist in the literature. The aim of this research was to determine the frequency and pattern of adverse drug reactions (ADRs) in HAART-experienced patients in our facility from

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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…”

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Adverse Reactions Associated with Antiretroviral Regimens in Adult Patients of a University Teaching Hospital HIV Program in Zaria, Northern Nigeria: An Observational Cohort Study

Reginald¹,

Haruna²,

Sani³

et al. 2012

J Antivir Antiretrovir

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“…Hb (g/dL) 10 On comparing the haemograms (Table 11) after six months, the mean haemoglobin levels after six months of therapy increased from 10.32 gm/dL to 10.52 gm/dL. Mean total count levels after six months of therapy were elevated from 6277 cells/cumm to 6594 cells/cumm.…”

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confidence: 99%

Study of Therapeutic Response to Second Line Art Regimen in Tertiary Care Teaching Hospital of South India

Pentakota¹,

C²,

Boddu³

2016

jemds

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BACKGROUNDThe widespread use of HAART therapy resulted in marked decline in the incidence of most AIDS defining conditions and mortality, both in the developed and developing world. As the scope of ART in developing countries continues, the number of patients failing in first line therapy and switching to second line therapy will inevitably increase. The aim of the study is to assess the therapeutic response by CD4 count and plasma viral load in HIV patients who received 2 nd line regimen consisting of tenofovir, lamivudine, Ritonavir and atazanavir.

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Gastrointestinal manifestations of human immunodeficiency virus and coronavirus disease 2019: Understanding the intersecting regions between the two epidemics

Cordie

Gaber

AbdAllah

et al. 2021

Arab Journal of Gastroenterology

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In March 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic. As of February 2021, there were 107 million COVID-19 cases worldwide. As a comparison, there are approximately 38 million people living with human immunodeficiency virus (PLHIV) worldwide. The coexistence of both epidemics, and the syndemic effect of both viruses could lead to a delirious impact both at individual and community levels. Many intersecting points were found between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, and HIV; among which, gastrointestinal (GI) manifestations are the most notable. GI manifestations represent a common clinical presentation in both HIV and SARS-CoV-2. The emergence of GI symptoms as a result of SARS-CoV-2 infection provides a new dynamic to COVID-19 diagnosis, management, and infection control measures, and adds an additional diagnostic challenge in case of coinfection with HIV. The presence of GI manifestations in PLHIV during the COVID-19 pandemic could be referred to HIV enteropathy, presence of opportunistic infection, adverse effect of antiretrovirals, or coinfection with COVID-19. Thus, it is important to exclude SARS-CoV-2 in patients who present with new-onset GI manifestations, especially in PLHIV, to avoid the risk of disease transmission during endoscopic interventions. Structural similarities between both viruses adds a valuable intersecting point, which has mutual benefits in the management of both viruses. These similarities led to the hypothesis that antiretrovirals such as lopinavir/Rironavir have a role in the management of COVID-19, which was the target of our search strategy using the available evidence. These similarities may also facilitate the development of an efficient HIV vaccine in the future using the advances in COVID-19 vaccine development.

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Three-Year Outcome Data of Second-Line Antiretroviral Therapy in Ugandan Adults: Good Virological Response but High Rate of Toxicity

Abstract: Our study confirms lopinavir/ ritonavir-based second-line regimen but with a high rate of toxicities.

Cited by 27 publications

References 14 publications

Adverse Reactions Associated with Antiretroviral Regimens in Adult Patients of a University Teaching Hospital HIV Program in Zaria, Northern Nigeria: An Observational Cohort Study

Adverse Reactions Associated with Antiretroviral Regimens in Adult Patients of a University Teaching Hospital HIV Program in Zaria, Northern Nigeria: An Observational Cohort Study

Study of Therapeutic Response to Second Line Art Regimen in Tertiary Care Teaching Hospital of South India

Gastrointestinal manifestations of human immunodeficiency virus and coronavirus disease 2019: Understanding the intersecting regions between the two epidemics

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