|
|
Research
Article
Treatment Outcomes in Patients Receiving Combination
Antiretroviral Therapy in Central Hospital, Benin City,
Nigeria
Kenneth A Agu*, Uche M Ochei, Azuka C Oparah and
Obialunamma U Onoh
1Department
of Clinical Pharmacy and Pharmacy Practice, University
of Benin, Benin City, 300001 Nigeria; 2 West
African Postgraduate College of Pharmacists, Lagos,
Nigeria.
*Corresponding author:
E-mail:
kenagpharm@yahoo.com
Received: 11 April 2009
Revised
accepted: 10 November 2009
Tropical
Journal of Pharmaceutical Research, February 2010;
9(1):
1-10
Abstract
Purpose:
This
study investigated mortality rate, early CD4 responses,
pattern of ARVs substitutions and medication adherence
of HIV-infected patients on first-line triple
combination antiretroviral therapy (ART) in Central
Hospital, Benin City, Nigeria.
Methods:
A retrospective assessment of 196 HIV-infected patients
on first-line combination ART regimens was performed
following 18 months of therapy. Medication adherence
assessment of a 69-patient follow-up target group was
based on a study-specific questionnaire. Paired sample
t-test and simple linear correlation were used to test
the association of the CD4-cell counts at different time
intervals. Kaplan-Meier model was used to assess
survival functions while log-rank test was applied to
assess statistical difference at 95 % confidence
interval (CI). Mean age of participants was 33.6 years
(95 % CI, 32.1 - 35.2; 67.9 % were females.
Results:
At ART initiation, 27.0 %
were at WHO clinical stage II, 47.0 % at stage III.
Mortality rate (N = 196) was 20.3 deaths per 100
patient-months; 31.6 % occurred in < 30 days while 52.6
% occurred post-120 days of treatment. The mean
CD4-cell count (cells/mm3) at ART
initiation was 179.2 which increased to 328.5 at
3 months, 325.6 at 6 months, 357.4 at 12 months,
and 366.7 at 18 months, (p < 0.01). Patients started on
stavudine-based or efavirenz-based regimens were
considerably more likely to have that drug substituted,
compared to patients started on zidovudine-based or
nevirapine-based regimens. The level of adherence
reported after 18 months on ART was 73.8 %.
Conclusion:
In this setting, patients
receiving ART showed significant improvements
in CD4-cell status but adherence level was relatively
poor. Patients were more stable on zidovudine-based or
nevirapine-based regimens than on stavudine-based or
efavirenz-based regimens. Early mortality rate was high,
indicating a need for early interventions.
Keywords:
Antiretroviral therapy;
HIV/AIDS; Mortality; Therapy outcomes, Nigeria |
