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