tailieunhanh - báo cáo hóa học:" Discontinuation of standard first-line antiretroviral therapy in a cohort of 1434 Malawian children"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : Discontinuation of standard first-line antiretroviral therapy in a cohort of 1434 Malawian children | Buck et al. Journal of the International AIDS Society 2010 13 31 http content 13 1 31 JOURNALOF THE INTERNATIONAL AIDS SOCIETY SHORT REPORT Open Access Discontinuation of standard first-line antiretroviral therapy in a cohort of 1434 Malawian children W Chris Buck1 Mark M Kabue2 Peter N Kazembe2 Mark W Kline3 Abstract The standard first-line antiretroviral ART regimen in Malawi for both adults and children is a fixed-dose combination tablet containing stavudine d4T lamivudine 3TC and nevirapine NVP . This regimen has been shown to yield satisfactory virologic and immunologic outcomes in children. Published studies have described insights into discontinuation of first-line regimen and toxicities of ART in adults but similar studies in paediatric populations are lacking. A retrospective cohort study was undertaken to assess reasons for discontinuation of the standard first-line ART regimen d4T 3TC NVP in a paediatric population. In total 1434 patients met eligibility criteria and were included. The cohort had mean and median age at ART initiation of years and years respectively range years . The gender distribution was 47 female and 53 male. Median follow-up time on ART was years range 2 years . A majority of patients were on the standard first-line ART regimen while 54 were on a different regimen. Twenty-eight patients were on an alternative first-line regimen due to toxi-cities 22 patients were on a second-line regimen due to ART failure and four patients were on a non-standard regimen for other clinical reasons. Of the 28 patients who experienced toxicities requiring ART regimen change 17 were caused by NVP 11 by d4T and none by 3TC. The median time from first-line ART initiation to alternative first-line ART was two months range 10 months of patients on alternative first-line ART were male. Average time on ART until switch to second-line ART regimen was .