Long-term effectiveness of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy in Ghana.
Identifieur interne : 000211 ( PubMed/Curation ); précédent : 000210; suivant : 000212Long-term effectiveness of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy in Ghana.
Auteurs : Fred S. Sarfo [Ghana] ; Maame Anima Sarfo ; Adetayo Kasim ; Richard Phillips ; Mark Booth ; David ChadwickSource :
- The Journal of antimicrobial chemotherapy [ 1460-2091 ] ; 2014.
Descripteurs français
- KwdFr :
- Abstention thérapeutique, Adulte, Adulte d'âge moyen, Analyse de survie, Antirétroviraux (pharmacologie), Antirétroviraux (usage thérapeutique), Benzoxazines (effets indésirables), Benzoxazines (pharmacologie), Benzoxazines (usage thérapeutique), Charge virale, Femelle, Ghana, Humains, Infections à VIH (traitement médicamenteux), Inhibiteurs de la transcriptase inverse (effets indésirables), Inhibiteurs de la transcriptase inverse (pharmacologie), Inhibiteurs de la transcriptase inverse (usage thérapeutique), Mâle, Numération des lymphocytes CD4, Névirapine (effets indésirables), Névirapine (pharmacologie), Névirapine (usage thérapeutique), Résultat thérapeutique, Thérapie antirétrovirale hautement active (), Études rétrospectives.
- MESH :
- effets indésirables : Benzoxazines, Inhibiteurs de la transcriptase inverse, Névirapine.
- pharmacologie : Antirétroviraux, Benzoxazines, Inhibiteurs de la transcriptase inverse, Névirapine.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Antirétroviraux, Benzoxazines, Inhibiteurs de la transcriptase inverse, Névirapine.
- Abstention thérapeutique, Adulte, Adulte d'âge moyen, Analyse de survie, Charge virale, Femelle, Ghana, Humains, Mâle, Numération des lymphocytes CD4, Résultat thérapeutique, Thérapie antirétrovirale hautement active, Études rétrospectives.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adult, Anti-Retroviral Agents (pharmacology), Anti-Retroviral Agents (therapeutic use), Antiretroviral Therapy, Highly Active (methods), Benzoxazines (adverse effects), Benzoxazines (pharmacology), Benzoxazines (therapeutic use), CD4 Lymphocyte Count, Female, Ghana, HIV Infections (drug therapy), Humans, Male, Middle Aged, Nevirapine (adverse effects), Nevirapine (pharmacology), Nevirapine (therapeutic use), Retrospective Studies, Reverse Transcriptase Inhibitors (adverse effects), Reverse Transcriptase Inhibitors (pharmacology), Reverse Transcriptase Inhibitors (therapeutic use), Survival Analysis, Treatment Outcome, Viral Load, Withholding Treatment.
- MESH :
- chemical , adverse effects : Benzoxazines, Nevirapine, Reverse Transcriptase Inhibitors.
- chemical , pharmacology : Anti-Retroviral Agents, Benzoxazines, Nevirapine, Reverse Transcriptase Inhibitors.
- chemical , therapeutic use : Anti-Retroviral Agents, Benzoxazines, Nevirapine, Reverse Transcriptase Inhibitors.
- geographic : Ghana.
- drug therapy : HIV Infections.
- methods : Antiretroviral Therapy, Highly Active.
- Adult, CD4 Lymphocyte Count, Female, Humans, Male, Middle Aged, Retrospective Studies, Survival Analysis, Treatment Outcome, Viral Load, Withholding Treatment.
Abstract
Information on the long-term effectiveness and tolerability of efavirenz- or nevirapine-based antiretroviral therapy (ART) in Africa is lacking. The primary objective of this retrospective observational study was to compare the long-term clinical and immunological outcomes of efavirenz- versus nevirapine-based first-line ART in a large government clinic in Ghana.
DOI: 10.1093/jac/dkt336
PubMed: 24003181
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Sarfo</name><affiliation wicri:level="1"><nlm:affiliation>Komfo Anokye Teaching Hospital, Kumasi, Ghana.</nlm:affiliation><country xml:lang="fr">Ghana</country><wicri:regionArea>Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea></affiliation></author><author><name sortKey="Sarfo, Maame Anima" sort="Sarfo, Maame Anima" uniqKey="Sarfo M" first="Maame Anima" last="Sarfo">Maame Anima Sarfo</name></author><author><name sortKey="Kasim, Adetayo" sort="Kasim, Adetayo" uniqKey="Kasim A" first="Adetayo" last="Kasim">Adetayo Kasim</name></author><author><name sortKey="Phillips, Richard" sort="Phillips, Richard" uniqKey="Phillips R" first="Richard" last="Phillips">Richard Phillips</name></author><author><name sortKey="Booth, Mark" sort="Booth, Mark" uniqKey="Booth M" first="Mark" last="Booth">Mark Booth</name></author><author><name sortKey="Chadwick, David" sort="Chadwick, David" uniqKey="Chadwick D" first="David" last="Chadwick">David Chadwick</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24003181</idno><idno type="pmid">24003181</idno><idno type="doi">10.1093/jac/dkt336</idno><idno type="wicri:Area/PubMed/Corpus">000211</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000211</idno><idno type="wicri:Area/PubMed/Curation">000211</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000211</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Long-term effectiveness of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy in Ghana.</title><author><name sortKey="Sarfo, Fred S" sort="Sarfo, Fred S" uniqKey="Sarfo F" first="Fred S" last="Sarfo">Fred S. 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des lymphocytes CD4</term><term>Névirapine (effets indésirables)</term><term>Névirapine (pharmacologie)</term><term>Névirapine (usage thérapeutique)</term><term>Résultat thérapeutique</term><term>Thérapie antirétrovirale hautement active ()</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Benzoxazines</term><term>Nevirapine</term><term>Reverse Transcriptase Inhibitors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Anti-Retroviral Agents</term><term>Benzoxazines</term><term>Nevirapine</term><term>Reverse Transcriptase Inhibitors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Retroviral Agents</term><term>Benzoxazines</term><term>Nevirapine</term><term>Reverse Transcriptase Inhibitors</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Benzoxazines</term><term>Inhibiteurs de la transcriptase inverse</term><term>Névirapine</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Antiretroviral Therapy, Highly Active</term></keywords><keywords scheme="MESH" qualifier="pharmacologie" xml:lang="fr"><term>Antirétroviraux</term><term>Benzoxazines</term><term>Inhibiteurs de la transcriptase inverse</term><term>Névirapine</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antirétroviraux</term><term>Benzoxazines</term><term>Inhibiteurs de la transcriptase inverse</term><term>Névirapine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>CD4 Lymphocyte Count</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Survival Analysis</term><term>Treatment Outcome</term><term>Viral Load</term><term>Withholding Treatment</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Abstention thérapeutique</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Charge virale</term><term>Femelle</term><term>Ghana</term><term>Humains</term><term>Mâle</term><term>Numération des lymphocytes CD4</term><term>Résultat thérapeutique</term><term>Thérapie antirétrovirale hautement active</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Information on the long-term effectiveness and tolerability of efavirenz- or nevirapine-based antiretroviral therapy (ART) in Africa is lacking. The primary objective of this retrospective observational study was to compare the long-term clinical and immunological outcomes of efavirenz- versus nevirapine-based first-line ART in a large government clinic in Ghana.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24003181</PMID><DateCreated><Year>2013</Year><Month>12</Month><Day>16</Day></DateCreated><DateCompleted><Year>2014</Year><Month>07</Month><Day>25</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1460-2091</ISSN><JournalIssue CitedMedium="Internet"><Volume>69</Volume><Issue>1</Issue><PubDate><Year>2014</Year><Month>Jan</Month></PubDate></JournalIssue><Title>The Journal of antimicrobial chemotherapy</Title><ISOAbbreviation>J. Antimicrob. Chemother.</ISOAbbreviation></Journal><ArticleTitle>Long-term effectiveness of first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy in Ghana.</ArticleTitle><Pagination><MedlinePgn>254-61</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/jac/dkt336</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">Information on the long-term effectiveness and tolerability of efavirenz- or nevirapine-based antiretroviral therapy (ART) in Africa is lacking. The primary objective of this retrospective observational study was to compare the long-term clinical and immunological outcomes of efavirenz- versus nevirapine-based first-line ART in a large government clinic in Ghana.</AbstractText><AbstractText Label="PATIENTS AND METHODS" NlmCategory="METHODS">The main outcomes were AIDS, death, ART-related toxicity, discontinuation of ART and a composite endpoint of death, AIDS or ART discontinuation. These time-to-event outcomes were compared using a Cox proportional hazards regression model. CD4 counts on ART were compared using a mixed-effects model.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 3990 patients started non-nucleoside reverse transcriptase inhibitor (NNRTI)-based ART between 2004 and 2010, of which 2369 (59%) were on efavirenz. No significant differences were apparent between each NNRTI for subsequent risk of AIDS, death or the composite of treatment failure; however, stavudine use was independently associated with an increased risk of death [adjusted hazard ratio (HR) 1.60 (95% CI: 1.21-2.11)]. There was an increased risk of early toxicity with nevirapine leading to discontinuation [adjusted HR 1.53 (95% CI: 1.23-1.97)], mostly due to excess skin rashes in the first 2 months of treatment; however, overall discontinuation rates were low.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">There was no difference in the long-term effectiveness of efavirenz- and nevirapine-based ART in this population; however, patients initiating nevirapine were more likely to develop early toxicity and discontinue this drug. The excess mortality observed in patients taking stavudine is of concern and should prompt increased efforts to replace it with alternative antiretroviral drugs in developing countries.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sarfo</LastName><ForeName>Fred S</ForeName><Initials>FS</Initials><AffiliationInfo><Affiliation>Komfo Anokye Teaching Hospital, Kumasi, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sarfo</LastName><ForeName>Maame Anima</ForeName><Initials>MA</Initials></Author><Author ValidYN="Y"><LastName>Kasim</LastName><ForeName>Adetayo</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Phillips</LastName><ForeName>Richard</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Booth</LastName><ForeName>Mark</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Chadwick</LastName><ForeName>David</ForeName><Initials>D</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>MRC_MR/J01477X/1</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>09</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Antimicrob Chemother</MedlineTA><NlmUniqueID>7513617</NlmUniqueID><ISSNLinking>0305-7453</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D044966">Anti-Retroviral 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="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D044966" MajorTopicYN="N">Anti-Retroviral Agents</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D023241" MajorTopicYN="N">Antiretroviral Therapy, Highly Active</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</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="N">CD4 Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N" Type="Geographic">Ghana</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</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="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="D012189" MajorTopicYN="N">Retrospective Studies</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="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019562" MajorTopicYN="N">Viral Load</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D028761" MajorTopicYN="N">Withholding Treatment</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">ART</Keyword><Keyword MajorTopicYN="N">Africa</Keyword><Keyword MajorTopicYN="N">HIV</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>9</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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