Incidence and risk factors of severe adverse events with nevirapine-based antiretroviral therapy in HIV-infected women. MTCT-Plus program, Abidjan, Côte d'Ivoire

Autor: Didier K. Ekouevi, Patrick A. Coffie, Aristophane Tanon, Clarisse Amani-Bosse, Elaine J. Abrams, François Dabis, Besigin Tonwe-Gold, Gédéon Bedikou
Přispěvatelé: Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, MTCT-Plus programme (ACONDA), MTCT-Plus programme, Service des maladies infectieuses et tropicales, CHU Treichville, MTCT-Plus Initiative, Columbia University [New York]-International Center for AIDS Care and Treatment Programs-Columbia Mailman School of Public Health, Mouillet, Evelyne, Columbia University [New York]
Jazyk: angličtina
Rok vydání: 2010
Předmět:
MESH: Exanthema
Prevalence
HIV Infections
Severity of Illness Index
MESH: Antiretroviral Therapy
Highly Active
0302 clinical medicine
Risk Factors
MESH: Risk Factors
Antiretroviral Therapy
Highly Active
030212 general & internal medicine
MESH: Incidence
MESH: Anti-HIV Agents
MESH: Nevirapine
0303 health sciences
Incidence
Incidence (epidemiology)
MESH: HIV Infections
Rash
3. Good health
Infectious Diseases
Female
Chemical and Drug Induced Liver Injury
medicine.symptom
Research Article
medicine.drug
Adult
medicine.medical_specialty
MESH: Drug-Induced Liver Injury
Nevirapine
Anti-HIV Agents
MESH: Cote d'Ivoire
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Internal medicine
MESH: Severity of Illness Index
parasitic diseases
medicine
Humans
lcsh:RC109-216
Adverse effect
Pregnancy
MESH: Humans
030306 microbiology
business.industry
Proportional hazards model
MESH: Adult
Exanthema
medicine.disease
Regimen
Cote d'Ivoire
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Immunology
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
MESH: Female
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, BioMed Central, 2010, 10, pp.188. ⟨10.1186/1471-2334-10-188⟩
BMC Infectious Diseases, Vol 10, Iss 1, p 188 (2010)
ISSN: 1471-2334
DOI: 10.1186/1471-2334-10-188⟩
Popis: Background In resource-limited settings where nevirapine-containing regimen is the preferred regimen in women, data on severe adverse events (SAEs) according to CD4 cell count are limited. We estimated the incidence of SAEs according to CD4 cell count and identify their risk factors in nevirapine-treated women. Methods All HIV-infected women who initiated nevirapine-containing regimen in the MTCT-Plus operational program in Abidjan, Côte d'Ivoire, were eligible for this study. Laboratory and clinical (rash) SAEs were classified as grade 3 and 4. Cox models were used to identify factors associated with the occurrence of SAEs. Results From August 2003 to October 2006, 290 women initiated a nevirapine-containing regimen at a median CD4 cell count of 186 cells/mm3 (IQR 124-266). During a median follow-up on treatment of 25 months, the incidence of all SAEs was 19.5/100 patient-years. The 24-month probability of occurrence of hepatotoxicity or rash was not different between women with a CD4 cell count >250 cells/mm3 and women with a CD4 cell count ≤250 cells/mm3 (8.3% vs. 9.9%, Log-rank test: p = 0.75). In a multivariate proportional hazard model, neither CD4 cell count >250 cells/mm3 at treatment initiation nor initiation NVP-based regimen initiated during pregnancy were associated with the occurrence of SAEs. Conclusion CD4 cell count >250 cells/mm3 was not associated with a higher risk of severe hepatotoxicity and/or rash, as well as initiation of ART during pregnancy. Pharmacovogilance data as well as meta-analysis on women receiving NVP in these settings are needed for better information about NVP toxicity.
Databáze: OpenAIRE
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