Abstract
Background:
Despite wide use of nevirapine- and efavirenz-based highly active antiretroviral therapy regimens in Ethiopia, their treatment outcome has not been well studied. The objective of this study was to compare treatment outcome of nevirapine- and efavirenz-based regimens.
Methods:
This retrospective cohort study was conducted on antiretroviral-naive adult patients with human immunodeficiency virus (HIV) who had started antiretroviral therapy. Study participants were excluded after treatment failure, regimen change, loss to follow-up, or transfer to other health facility. The outcomes of interest included immunologic recovery, immunologic failure, clinical failure, and treatment failure.
Results:
There were 1064 HIV patients in the study; an equal proportion (1:1) from both efavirenz- and nevirapine-based regimens was included. Patients in both regimens had similar baseline CD4 cells count (P = .876). In multivariate analysis, efavirenz-based regimens showed more likelihood of immunologic recovery, whether defined as a CD4 cell count of >200 cells/mm3 (hazard ratio [HR] = 1.31 [95% CI, 1.05-1.59]), >350 cells/mm3 (HR = 1.26 [95% CI, 1.08-1.47]), or >500 cells/mm3 (HR = 1.95 [95% CI, 1.57-2.41]). Moreover, efavirenz-based regimens showed a lower hazard of treatment failure (HR = 0.66 [95% CI, 0.49-0.88]).
Conclusion:
Although the finding of retrospective study should be interpreted with caution, efavirenz-based regimens were associated with superior treatment outcome.
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