Comparing the effectiveness of efavirenz and nevirapine for first-line antiretroviral therapy in a South African multicentre cohort.
Identifieur interne : 001646 ( PubMed/Corpus ); précédent : 001645; suivant : 001647Comparing the effectiveness of efavirenz and nevirapine for first-line antiretroviral therapy in a South African multicentre cohort.
Auteurs : Peter Bock ; Geoffrey Fatti ; Ashraf GrimwoodSource :
- International health [ 1876-3405 ] ; 2013.
English descriptors
- KwdEn :
- Adolescent, Adult, Anti-HIV Agents (pharmacology), Anti-HIV Agents (therapeutic use), Benzoxazines (adverse effects), Benzoxazines (pharmacology), Benzoxazines (therapeutic use), CD4 Lymphocyte Count, Cohort Studies, Female, HIV Infections (drug therapy), HIV Infections (mortality), HIV Infections (virology), Humans, Male, Middle Aged, Nevirapine (pharmacology), Nevirapine (therapeutic use), Pregnancy, Proportional Hazards Models, Reverse Transcriptase Inhibitors (adverse effects), Reverse Transcriptase Inhibitors (pharmacology), Reverse Transcriptase Inhibitors (therapeutic use), South Africa, Treatment Outcome, Viral Load (drug effects), Young Adult.
- MESH :
- chemical , adverse effects : Benzoxazines, Reverse Transcriptase Inhibitors.
- chemical , pharmacology : Anti-HIV Agents, Benzoxazines, Nevirapine, Reverse Transcriptase Inhibitors.
- chemical , therapeutic use : Anti-HIV Agents, Benzoxazines, Nevirapine, Reverse Transcriptase Inhibitors.
- geographic : South Africa.
- drug effects : Viral Load.
- drug therapy : HIV Infections.
- mortality : HIV Infections.
- virology : HIV Infections.
- Adolescent, Adult, CD4 Lymphocyte Count, Cohort Studies, Female, Humans, Male, Middle Aged, Pregnancy, Proportional Hazards Models, Treatment Outcome, Young Adult.
Abstract
Current WHO guidelines for developing countries recommend efavirenz (EFV) and nevirapine (NVP) for first-line antiretroviral treatment (ART). This paper compares the effectiveness of EFV and NVP among ART-naive patients initiating treatment at 56 public health facilities in South Africa between January 2004 and December 2007.
DOI: 10.1093/inthealth/iht002
PubMed: 24030113
Links to Exploration step
pubmed:24030113Le document en format XML
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This paper compares the effectiveness of EFV and NVP among ART-naive patients initiating treatment at 56 public health facilities in South Africa between January 2004 and December 2007.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24030113</PMID><DateCreated><Year>2013</Year><Month>09</Month><Day>13</Day></DateCreated><DateCompleted><Year>2014</Year><Month>08</Month><Day>26</Day></DateCompleted><DateRevised><Year>2016</Year><Month>05</Month><Day>11</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1876-3405</ISSN><JournalIssue CitedMedium="Internet"><Volume>5</Volume><Issue>2</Issue><PubDate><Year>2013</Year><Month>Jun</Month></PubDate></JournalIssue><Title>International health</Title><ISOAbbreviation>Int Health</ISOAbbreviation></Journal><ArticleTitle>Comparing the effectiveness of efavirenz and nevirapine for first-line antiretroviral therapy in a South African multicentre cohort.</ArticleTitle><Pagination><MedlinePgn>132-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/inthealth/iht002</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Current WHO guidelines for developing countries recommend efavirenz (EFV) and nevirapine (NVP) for first-line antiretroviral treatment (ART). This paper compares the effectiveness of EFV and NVP among ART-naive patients initiating treatment at 56 public health facilities in South Africa between January 2004 and December 2007.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Participants were assigned to the EFV or NVP cohorts depending on their baseline ART regimen. Mortality, viral load suppression after 6 months and ART regimen change were compared between the cohorts using Cox proportional hazards models and logistic regression.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">At initiation, 19 441 (71.1%) patients started EFV and 7909 (28.9%) started NVP treatment. The median follow-up period was 9.5 months (IQR 4.6-17.7). After adjustment, mortality was similar in the two cohorts, (adjusted HR = 1.07, 95% CI 0.89-1.28). Viral load suppression at 6 months was higher in the EFV cohort overall (adjusted odds ratio [AOR] = 1.29, 95% CI 1.05-1.59) and in women aged 16-40 years (AOR = 1.35, 95% CI 1.11-1.63) and women with CD4 counts <25 cells/µL (AOR = 1.95, 95% CI 1.01-3.76). Patients starting on EFV were 47% less likely to change regimen (AOR = 0.53, 95% CI 0.48-0.59).</AbstractText><AbstractText Label="DISCUSSION" NlmCategory="CONCLUSIONS">These findings suggest the superior effectiveness of EFV for first-line ART compared with NVP and should be considered during development of future ART guidelines for high-burden regions.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bock</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Kheth'Impilo, Green Square, 37 Hares Crescent, Woodstock, 7925, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fatti</LastName><ForeName>Geoffrey</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>Grimwood</LastName><ForeName>Ashraf</ForeName><Initials>A</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Int Health</MedlineTA><NlmUniqueID>101517095</NlmUniqueID><ISSNLinking>1876-3405</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D048588">Benzoxazines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018894">Reverse Transcriptase Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>99DK7FVK1H</RegistryNumber><NameOfSubstance UI="D019829">Nevirapine</NameOfSubstance></Chemical><Chemical><RegistryNumber>JE6H2O27P8</RegistryNumber><NameOfSubstance UI="C098320">efavirenz</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D048588" MajorTopicYN="N">Benzoxazines</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018791" MajorTopicYN="Y">CD4 Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019829" MajorTopicYN="N">Nevirapine</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011247" MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018894" MajorTopicYN="N">Reverse Transcriptase Inhibitors</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013019" MajorTopicYN="N" Type="Geographic">South Africa</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019562" MajorTopicYN="N">Viral Load</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">AIDS</Keyword><Keyword MajorTopicYN="N">Antiretrovirals</Keyword><Keyword MajorTopicYN="N">Efavirenz</Keyword><Keyword MajorTopicYN="N">Guidelines</Keyword><Keyword MajorTopicYN="N">Nevirapine</Keyword><Keyword MajorTopicYN="N">Teratogencity</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>9</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>9</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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