Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings
There is limited information on efficacy and durability of second-line antiretroviral therapy (2NL) beyond 12 months in resource-limited settings. A total of 73 patients were enrolled into a prospective 2NL observational cohort in Nigeria. Second-line antiretroviral therapy consisted of lopinavir/ri...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2014-07-01
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| Series: | Journal of the International Association of Providers of AIDS Care |
| Online Access: | https://doi.org/10.1177/2325957414527167 |
| _version_ | 1811286508381929472 |
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| author | Olukemi Osinusi-Adekanmbi MD, MPH Kristen Stafford MPH Adiba Ukpaka MBBS Donald Salami MSc Samuel Ajayi MBBS Nicaise Ndembi PhD Alash’le Abimiku PhD Chidi Nwizu MD Bruce Gilliam MD Robert Redfield MD Anthony Amoroso MD |
| author_facet | Olukemi Osinusi-Adekanmbi MD, MPH Kristen Stafford MPH Adiba Ukpaka MBBS Donald Salami MSc Samuel Ajayi MBBS Nicaise Ndembi PhD Alash’le Abimiku PhD Chidi Nwizu MD Bruce Gilliam MD Robert Redfield MD Anthony Amoroso MD |
| author_sort | Olukemi Osinusi-Adekanmbi MD, MPH |
| collection | DOAJ |
| description | There is limited information on efficacy and durability of second-line antiretroviral therapy (2NL) beyond 12 months in resource-limited settings. A total of 73 patients were enrolled into a prospective 2NL observational cohort in Nigeria. Second-line antiretroviral therapy consisted of lopinavir/ritonavir plus nucleoside reverse transcriptase inhibitors. Time on 2NL ranged from 15 to 31 months. Genotypes were retrospectively done and not available to guide second-line regimen choice. At enrollment, median CD4 count was 121 cells/mm 3 , and median time on first-line antiretroviral therapy (1SL) was 24 months. At 6 to 9 months on 2NL, 72.6% (intention to treat [ITT]) and 88.3% (on treatment [OT]) had an undetectable viral load (UDVL). At 12 months, 65.8% (ITT) and 90.57% (OT) had UDVL. At >12 to 24 months and at >24 months, 57.5% (ITT) and 91.3% (OT) had UDVL. No statistically significant association was observed between CD4 at 2NL start, sex, genotypic sensitivity score of 2NL, or tenofovir (TDF) use in 1SL and viral suppression. Two patients developed major protease inhibitor mutations while on 2NL. We observed a high degree of viral suppression at 12 months and little loss of viral suppression thereafter. |
| first_indexed | 2024-04-13T03:01:51Z |
| format | Article |
| id | doaj.art-b0070c8fd6364df39b3ed493558d5b1c |
| institution | Directory Open Access Journal |
| issn | 2325-9574 2325-9582 |
| language | English |
| last_indexed | 2024-04-13T03:01:51Z |
| publishDate | 2014-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of the International Association of Providers of AIDS Care |
| spelling | doaj.art-b0070c8fd6364df39b3ed493558d5b1c2022-12-22T03:05:24ZengSAGE PublishingJournal of the International Association of Providers of AIDS Care2325-95742325-95822014-07-011310.1177/2325957414527167Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited SettingsOlukemi Osinusi-Adekanmbi MD, MPH0Kristen Stafford MPH1Adiba Ukpaka MBBS2Donald Salami MSc3Samuel Ajayi MBBS4Nicaise Ndembi PhD5Alash’le Abimiku PhD6Chidi Nwizu MD7Bruce Gilliam MD8Robert Redfield MD9Anthony Amoroso MD10 Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA AIDSRelief, Abuja, Federal Capital Territory, Nigeria AIDSRelief Jos, Plateau State, Nigeria Department of Medicine, University of Abuja Teaching Hospital, Gwagwaladda, Federal Capital Territory, Nigeria Institute of Human Virology Nigeria, Abuja, Federal Capital Territory, Nigeria Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USAThere is limited information on efficacy and durability of second-line antiretroviral therapy (2NL) beyond 12 months in resource-limited settings. A total of 73 patients were enrolled into a prospective 2NL observational cohort in Nigeria. Second-line antiretroviral therapy consisted of lopinavir/ritonavir plus nucleoside reverse transcriptase inhibitors. Time on 2NL ranged from 15 to 31 months. Genotypes were retrospectively done and not available to guide second-line regimen choice. At enrollment, median CD4 count was 121 cells/mm 3 , and median time on first-line antiretroviral therapy (1SL) was 24 months. At 6 to 9 months on 2NL, 72.6% (intention to treat [ITT]) and 88.3% (on treatment [OT]) had an undetectable viral load (UDVL). At 12 months, 65.8% (ITT) and 90.57% (OT) had UDVL. At >12 to 24 months and at >24 months, 57.5% (ITT) and 91.3% (OT) had UDVL. No statistically significant association was observed between CD4 at 2NL start, sex, genotypic sensitivity score of 2NL, or tenofovir (TDF) use in 1SL and viral suppression. Two patients developed major protease inhibitor mutations while on 2NL. We observed a high degree of viral suppression at 12 months and little loss of viral suppression thereafter.https://doi.org/10.1177/2325957414527167 |
| spellingShingle | Olukemi Osinusi-Adekanmbi MD, MPH Kristen Stafford MPH Adiba Ukpaka MBBS Donald Salami MSc Samuel Ajayi MBBS Nicaise Ndembi PhD Alash’le Abimiku PhD Chidi Nwizu MD Bruce Gilliam MD Robert Redfield MD Anthony Amoroso MD Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings Journal of the International Association of Providers of AIDS Care |
| title | Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings |
| title_full | Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings |
| title_fullStr | Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings |
| title_full_unstemmed | Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings |
| title_short | Long-Term Outcome of Second-Line Antiretroviral Therapy in Resource-Limited Settings |
| title_sort | long term outcome of second line antiretroviral therapy in resource limited settings |
| url | https://doi.org/10.1177/2325957414527167 |
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