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Provedor de dados:  BJMBR
País:  Brazil
Título:  Comparison of the effectiveness of initial combined antiretroviral therapy with nelfinavir or efavirenz at a university-based outpatient service in Brazil
Autores:  Vanni,T.
Morejón,K.M.
Santana,R.C.
Melo,L. de
Ferrão,S.B.R.L.
Amorim,A.P.
Gaspar,G.G.
Ponzi,C.C.
Golin,N.A.
Custódio,F.L.
Marangoni,A.T.D.
Campos Jr.,C.P.
Fonseca,B.A.L.
Data:  2007-07-01
Ano:  2007
Palavras-chave:  AIDS
HIV
Antiretroviral treatment
Efavirenz
Nelfinavir
Highly active antiretroviral therapy
Resumo:  Since there are some concerns about the effectiveness of highly active antiretroviral therapy in developing countries, we compared the initial combination antiretroviral therapy with zidovudine and lamivudine plus either nelfinavir or efavirenz at a university-based outpatient service in Brazil. This was a retrospective comparative cohort study carried out in a tertiary level hospital. A total of 194 patients receiving either nelfinavir or efavirenz were identified through our electronic database search, but only 126 patients met the inclusion criteria. Patients were included if they were older than 18 years old, naive for antiretroviral therapy, and had at least 1 follow-up visit after starting the antiretroviral regimen. Fifty-one of the included patients were receiving a nelfinavir-based regimen and 75 an efavirenz-based regimen as outpatients. Antiretroviral therapy was prescribed to all patients according to current guidelines. By intention-to-treat (missing/switch = failure), after a 12-month period, 65% of the patients in the efavirenz group reached a viral load <400 copies/mL compared to 41% of the patients in the nelfinavir group (P = 0.01). The mean CD4 cell count increase after a 12-month period was also greater in the efavirenz group (195 x 10(6) cells/L) than in the nelfinavir group (119 x 10(6) cells/L; P = 0.002). The efavirenz-based regimen was superior compared to the nelfinavir-based regimen. The low response rate in the nelfinavir group might be partially explained by the difficulty of using a regimen requiring a higher patient compliance (12 vs 3 pills a day) in a developing country.
Tipo:  Info:eu-repo/semantics/article
Idioma:  Inglês
Identificador:  http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2007000700011
Editor:  Associação Brasileira de Divulgação Científica
Relação:  10.1590/S0100-879X2007000700011
Formato:  text/html
Fonte:  Brazilian Journal of Medical and Biological Research v.40 n.7 2007
Direitos:  info:eu-repo/semantics/openAccess
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