AEGiS-15IAC: Treatment outcomes and Adherence to Generic TriomuneÃ¢Â„Â¢ and MaxivirÃ¢Â„Â¢ therapy in Kampala, Uganda.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Treatment outcomes and Adherence to Generic Triomune ó ä ó and Maxivir ó ä ó therapy in Kampala, Uganda.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1323)

Oyugi JH, Byakika JT, Ragland K, Mugyenyi P, Kityo C, Mugerwa R, Bangsberg DR
University of California San Francisco and Academic Alliance for AIDS Care and Prevention in Africa, San Francisco, United States

BACKGROUND: Market competition, reductions in drug pricing and low cost make generic antiretroviral drug regimens widely prescribed in resource-poor settings. Triomune ó ä ó (Tri) and Maxivir ó ä ó (Max), generic co-formulations of D4T/3TC/nevirapine are amongst the least expensive ARVs worldwide, yet lack thorough evaluation. Our objective was to measure adherence, virologic and immunologic response in patients initiating Tri/Max.

METHODS: ARV treatment naïve patients initiating self-pay Tri/Max in Kampala were recruited into the Adherence Monitoring Uganda (AMU) cohort. Adherence (ADH) was measured monthly by 3-day self-report(SR), visual analog scale(VAS), unannounced home pill counts(PC) and electronic medication event monitoring(MEMS). HIV RNA-PCR was determined at baseline, 12 and 24 weeks. CD4 cell count was determined at baseline and 24 weeks.

RESULTS: 70 patients were recruited. Demographic data showed: mean age=35, female=62%, income<100,000 Ugandan shillings/month (~$50USD)=53.6%, unemployed=20%, median pretreatment CD4=62cells/ml and median pretreatment HIV RNA=262,903 copies/ml. At this analysis, 60 participants completed 12-weeks with these outcomes: HIV RNA<400 copies/ml=78%, mean PC ADH =93%, mean SR ADH=92%, mean VAS ADH=91% and mean MEMS ADH=94%. 32 patients completed 24-weeks with the following outcomes: HIV RNA<400 copies/ml=78%, mean PC ADH=86%, mean SR ADH=85%, mean VAS ADH=88% and mean MEMS ADH=82%. At 24 weeks, mean CD4 cell count rise was 122 cells/ml. 8.6% of participants died in follow-up, within 2 months of treatment initiation. 12.9% discontinued treatment, usually due to initiation of TB therapy.

CONCLUSIONS: Patients self-purchasing generic ARV co-formulations in Kampala, Uganda have excellent adherence, high rates of viral suppression and CD4 cell count increases at 24 weeks.

Keywords: AEGIS, CD4 Lymphocyte Count, Treatment Outcome, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, HIV Infections, HIV Protease Inhibitors, HIV-1, Lamivudine, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Drug Therapy, Combination, Uganda, Female, Humans, therapy, drug therapy

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WeOrB1323