scholarly journals Outcome of Fixed Dose Combination of Tenofovir, Lamivudine and Dolutegravir in Rural HIV Care Facility in Nigeria

2021 ◽  
Vol 11 (12) ◽  
pp. 1-8
Author(s):  
Ogbuagu Chukwuanugo Nkemakonam ◽  
Ogbuagu Ekenechukwu Nkiloka ◽  
Okoh Emeka Emmanuel

Background: Antiretroviral therapy (ART) has significantly increased the lifespan of people living with HIV. Currently, fixed dosed combination therapy (Tenofovir, Lamivudine, and Dolutegravir) is being introduced in most countries in the Sub- Saharan Africa. There is need for a clinical and immunological assessment of HIV patients transitioned to this new therapy over a period of 2 years. Objectives: To determine the proportion of patients whose viral load was suppressed to <20 copies/ml following two years therapy with Dolutegravir-based fixed-dose combination therapy. Methods: This retrospective cohort study was carried out in a Comprehensive Healthcare Centre (CHC), a facility affiliated with Nnamdi Azikiwe University Teaching Hospital Nigeria. The primary outcome measure was the proportion of patients whose viral load was suppressed to <20 copies/ml. The plasma viral load (HIV-RNA) assay was done using real time PCR and CD4+ T- lymphocyte (CD4+) counts were estimated using Flow Cytometry. The exclusion criteria were patients who has invalid data base and patients with comorbidities associated with HIV. Results: A total of 537 HIV1 sero-positive patients were enrolled for ART care over a period of 2 years (2017-2018). Females in the age group (41-50 years) constituted the bulk (36.9%) of the patients whilst the least (5.3%) were males in the age group (8 to 30 years). The mean CD4 count of patients was 847.35cells/mm3. More females (45.9%) had CD4+counts over 500cells/mm3 whilst the percentage of males with CD4+ cell counts over 500cells/mm3 was 43.8%. Majority, 405 constituting 75.4% of the patients have suppressed viral load (<20 copies/ml) signifying that the centre is achieving success with respect to service delivery and ART. Patients with unsuppressed viral loads were more among Females with CD4+ counts in the range of 200-499 cells/mm3and this may be as a result of other associated factors which will be elucidated in future studies. Conclusion: Dolutegravir-based fixed-dose combination therapy suppressed viral load to <20 copies/ml in more than 75% of patients receiving the therapy. Enhanced adherence and effective doctor-patient relationship could be associated with the viral suppression observed in this study. Key words: Immunology, virology, HIV Outcome, Dolutegravir-based combination therapy, anti retroviral therapy.

Author(s):  
Fadhil Ilham Mustafa ◽  
◽  
Nurfitri Bustamam ◽  
Andri Pramesyanti ◽  
◽  
...  

Background: People living with HIV / AIDS (PLWHA) have weak immune systems and are prone to infection. Therefore, PLWHA must take antiretroviral (ARV) to maintain their immunity. This study aimed to determine the relationship between the level of adherence to taking ARV fixed-dose combination (FDC) drugs and CD4 levels of HIV patients. Subjects and Method: This was a cross-sectional study conducted at Pengayoman Cipinang Hospital, Indonesia, in 2018. Total of 91 HIV patient over 17 years of age, had or had received FDC ARV therapy for at least 1 year, and did not experience drug-induced hepatitis were enrolled in this study. The dependent variable was CD4 level. The independent variable was level of adherence to taking ARV fixed-dose combination (FDC). The data were taken from the Voluntary Counseling and Testing Poli Pengayoman Cipinang Hospital. This study used secondary data from the Overview of HIV Care and ARV Therapy. The data were analyzed using Chi-square. Results: A total of 65.93% HIV patients had a good level of medication adherence and 79.12% had an increase of CD4 levels. There was a significant relationship between adherence to taking FDC ARV drugs and CD4 levels (OR = 6.50; 95% CI = 2.15 to 19.62; p<0.001), and it was statistically significant. Conclusion: There is a significant relationship between the level of adherence to taking FDC ARV drugs and CD4 levels. Therefore, patients must receive education and support to improve adherence to taking ARV drugs. Keywords: antiretroviral, CD4, fixed-dose combination, adherence to taking medication, people with HIV / AIDS Correspondence: Fadhil Ilham Mustafa. Faculty of Medicine, Universitas Pembangunan Nasional Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta. Email: [email protected]. Mobile: 081283681755. DOI: https://doi.org/10.26911/the7thicph.02.03


1997 ◽  
Vol 90 (Supplement) ◽  
pp. 10-11
Author(s):  
William J. Elliott

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