Effectiveness and Side Effects of Therapy Using a 3-drug Antiretroviral Tablet: Nevirapine/Stavudine/Lamivudine (GPOvir) in HIV-infected Patients

Abstract

Effectiveness and Side Effects of Therapy Using a 3-drug Antiretroviral Tablet:  Nevirapine/Stavudine/Lamivudine (GPOvir) in HIV-infected Patients

Warangkana   Munsakul       MD

Petch                Rawdaree      MD, MSc Epidermiology, DLSHTM

Natee                Munsakuo      MD

*Department of Medicine, BMA Medical College and Vajira Hospital

Objective: To determine the effectiveness and side effects of the 3 drug antiretroviral tablet: nevirapine/stavudine/lamivudine (GPOvir) in treatment of HIV- infected patients.

Study design: Analytic longitudinal study

Subjects: Eighty-seven HIV -infected patients who were treated with GPOvir from April 2002 to November 2002 in Infectious Diseases Clinic, Department of Medicine, BMA Medical College and Vajira Hospital.

Methods: Sex, body weight, history of taking antiretroviral agent and CD4+cell count were recorded when starting GPOvir.  After following up for 3 months, body weight and CD4+cell count were recorded again.  Side effects were also recorded.  The data were analyzed to determine the outcomes and influence variables.

Main outcome measures: Body weight, CD4+cell count and side effects.

Results: Severe side effects were occurred in 13 cases (14.94%). The most common side effect was rash (13.79%), severe form of rash were found 10.34% and one case developed Stevens-Johnson syndrome,  The 74 of 87 patients were completely received 3 months of therapy.  Mean CD4+cell countless increased 99.250 cell/mm³ mean body weight increased 2.892 kg. The patients who had CD4+cell count less than or equal 100 cell/ mm³ had better response than the others, but no statistically significant difference.  Male patients had better response than female patients, but no statistically significant difference.  High body weight patients (greater than or equal 50 kg) had better response statistically significant than the others. Naïve patients had better response than antiretroviral-experienced patients with statistically significant difference.

Conclusion: This study demonstrated that GPOvir was effective in the treatment of HIV-infected patients. The significant factors associated with good outcomes were body weight and history of antiretroviral treatment.  The most common side effect was rash.  Severe side effects were 14.94%

Key word: nevirapine, stavudine, lamivudine, effectiveness, side effect.

Vajira Med J 2003 ; 47 : 29 - 36