Three-year outcome data of second-line antiretroviral therapy in Ugandan adults: good virological response but high rate of toxicityThree-year outcome data of second-line antiretroviral therapy in Ugandan adults: good virological response but high rate of toxicity
Faculty of Medicine and Health Sciences
Epidemiology and social medicine (ESOC)
2009Chicago, Ill., 2009
Journal of the International Association of Physicians in AIDS Care. - Chicago, Ill.
8(2009):1, p. 52-59
University of Antwerp
Objective. To evaluate the safety and virological response to lopinavir/ritonavir containing second-line therapy after failing a first line nonnucleoside reverse transcriptase inhibitor (NNRTI) based regimen. Design. Prospective 36 months cohort study of patients switched to zidovudine/stavudine plus didanosine plus lopinavir/ritonavir capsules as second-line regimen. Methodology. Structured interview, medical examination, and laboratory assessment performed every 6 months. Results. We enrolled 40 patients; 1 died and 3 were lost to follow-up. Median CD4+ count at baseline was 108 cell/µL, median log viral load was 4.8 copies/mL. Sixteen (40%) patients had baseline genotypic resistant test, 14 (87%) had lamivudine resistance mutations, and all had NNRTIs resistance mutations. At month 36, 82% of the patients achieved viral suppression (<400 copies/ mL) and the median increase in CD4+ count was 214 cell/µL, (interquartile range: 128-295). Twenty-five patients (62%) experienced at least one adverse event. Conclusions. Our study confirms lopinavir/ ritonavir-based second-line regimen but with a high rate of toxicities.