Nevirapine versus Efavirenz - based Highly Active Antiretroviraltherapy Regimens in Antiretroviral-Naïve Patients with HIV Infection: Comparison of Clinical and Immunological Response in Pratumthanee Hospital

Authors

  • วรรณสิทธิ์ เธียระวิบูลย์ Pratumthanee Hospital

Keywords:

HIV, Antiretroviral therapy, Pratumthanee Hospital

Abstract

The objective of this study was to compare clinical and immunological response to Navirapine and Efavirenz-based highly active antiretroviral regimens in antiretroviral naive patients with baseline CD4 count of < 250 cell/ml. A retrospective observational cohort study was conducted on antiretroviral naïve HIV-infected patients who had commenced HAART since 2002 and who had a starting CD4 count less than 250 cell/ml. Patients characteristic, epidemiological data and relevant clinical data were collected. It was found that most baseline characteristics of patients in the Navirapine ( n = 165 ) and Efavirenz ( n = 41 ) group were not different except the initial CD4 count, ALT level, staging and previous opportunistic infection, due to clinical selection of the patients. The clinical and immunological response to Navirapine-based and Efavirenz-based HAART regimens were similar at 1 year after treatment. The mean weight before treatment, 6 and 12 months after treatment were 53.7, 57.6 and 58.6 kg. in the Navirapine group and 56, 61.2 and 61.3 kg. in Efavirenz group respectively. The mean CD4 count before treatment, 6 and 12 months after treatment were 75.8, 192.6 and 261.5 cell/ml in the Navirapine group and 44.1, 156.4 and 243.6 cell/ml in the Efavirenz group respectively. In conclusion, Navirapine and Efavirenz-based HAART regimens as initial regimens in patients with HIV infection were effective and comparable in term of clinical and immunological response. However, further large-scale randomized controlled clinical trials should be conducted.

References

1. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency viras infection. HIV Out patient Study Investigators. N Engl J Med 1998; 338: 853-860

2. Mouton Y, Alfandari S, Valette M et al. Impact of protease inhibitors on AIDS-defining events and hospitalization in 10 French AIDS reference centers. Federation National des Centres de Lutte le SIDA. AIDS 1997: 11: F101-F105

3. Mocroft A, Vella S, Berfield TL et al. Changing pattern of mortality across Europe in patients infected with HIV-1. Lancet 1998; 352: 1725-1730

4. Yeni PG, Hammer SM, Carpenter CC et al. Antiretroviral treatment for adult HIV infection in 2002: updated recommendations of the International AIDS Society-USA Panel. J Am Med Assoc 2002; 288: 222-235

5. BHIVA Writing Committee on behalf of the BHIVA Executive Committee. British HIV Association ( BHIVA ) guidelines for the treatment of HIV-infected adults with antiretroviral therapy. HIV Med 2000; 1: 133-136

6. Delfraissy JF. New French guidelines for antiretroviral treatment. HIV Med 2000; 1: 133-136

7. W Manosithi, S Sungkanuparph, A Vibhagool et al. Nevirapine- versus efavirenz-based highly active antiretroviral therapy regimens in antiretroviral-na?ve patients with advanced HIV infection. HIV Med 2004; 5: 105-109

8. AK Patel, S Pujari, K Patel et al. Nevirapine Versus Efavirenz Based Antiretroviral Treatment in Na?ve Indian Patients : Comparison of Effectiveness in Clinical Cohort. JAPI 2006; 54: 915-918

9. L Waters, J Stebbing, R Jones et al. A comparison of the CD4 response to antiretroviral regimens in patients commencing therapy with low CD4 counts. J Antimicrob Chemother 2004; 54: 503-507

10. สัญชัย ชาสมบัติ, ชีวนันท์ เลิศพิริยสุวัฒน์, พรทิพย์ ยุกตานนท์. แนวทางการปฏิบัติงานโครงการ การพัฒนาระบบบริการและติดตามผลการรักษาผู้ติดเชื้อเอชไอวีและผู้ป่วยเอดส์ ด้วยยาต้านไวรัสเอดส์ พ.ศ.2546 กระทรวงสาธารณสุข, พิมพ์ครั้งที่ 2. กรุงเทพมหานคร: ร.ส.พ; 2546: 17-50.

11. ทวีทรัพย์ ศิรประภาศิริ, อิสระ เจียวิริยะบูญญา, ชีวนันท์ เลิศพิริยสุวัฒน์ . แนวทางการปฏิบัติงานการพัฒนาระบบบริการและติดตามผลการรักษาผู้ติดเชื้อเอชไอวีและผู้ป่วยเอดส์ด้วยยาต้านไวรัสในประเทศไทย ปี 2545, พิมพ์ครั้งที่ 1. กรุงเทพมหานคร : โรงพิมพ์ เจ เอส การพิมพ์ ; 2545 : 7-42.

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Published

2008-06-30

How to Cite

1.
เธียระวิบูลย์ ว. Nevirapine versus Efavirenz - based Highly Active Antiretroviraltherapy Regimens in Antiretroviral-Naïve Patients with HIV Infection: Comparison of Clinical and Immunological Response in Pratumthanee Hospital. Dis Control J [Internet]. 2008 Jun. 30 [cited 2024 Mar. 29];34(2):188-94. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/156213

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Original Article