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. 2008 Nov 12;22(17):2303-11.
doi: 10.1097/QAD.0b013e3283129db0.

Five-year outcomes of initial patients treated in Botswana's National Antiretroviral Treatment Program

Hermann Bussmann  1 , C William Wester, Ndwapi Ndwapi, Nicolas Grundmann, Tendani Gaolathe, John Puvimanasinghe, Ava Avalos, Madisa Mine, Khumo Seipone, Max Essex, Victor Degruttola, Richard G Marlink
Affiliations

Five-year outcomes of initial patients treated in Botswana's National Antiretroviral Treatment Program

Hermann Bussmann et al. AIDS. .

Abstract

Background: Antiretroviral treatment (ART) initiatives have now been established in many sub-Saharan African countries showing early benefits. To date, few results are available concerning long-term clinical outcomes in these treatment programs.

Methods: Response to ART is described in the first HIV-1C-infected adults enrolled in the Botswana Antiretroviral Treatment Program in 2002. Data analysis was conducted on available longitudinal data up to 1st April 2007.

Results: Six hundred thirty-three severely immunodeficient patients with a median CD4+ cell count of 67 cells/microl were initiated on non-nucleoside reverse transcriptase inhibitor-based combination ART and followed for a median of 41.9 months. The median CD4+ cell count increases were 169, 302, and 337 cells/microl at 1, 3, and 5 years, respectively. The percentages of patients with a viral load of less than 400 copies/ml at 1, 3, and 5 years were 91.3, 90.1, and 98.3%, respectively. Seventy-five percent of patients did not miss a single, or missed only one, monthly ART pickup per year with a mean pickup rate of 92.5%. The Kaplan-Meier survival estimates [95% confidence interval (CI)] at 1, 3, and 5 years were 82.7% (81.2 and 84.3%), 79.3% (77.6 and 81.0%), and 79.0% (77.3 and 80.7%), respectively. At 6 months, the risk of treatment modification for anemia was 6.94% (5.9 and 8.0%) for cutaneous hypersensitivity reactions, 1.3% (0.8 and 1.7%), and 1.1% (0.7 and 1.6%) for hepatotoxicity.

Conclusion: This initial group of adults on ART in Botswana had excellent sustained immunologic, virologic, and clinical outcomes for up to 5 years of follow-up with low mortality among those surviving into the second year of ART.

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Figures

Figure 1
Figure 1
Status of first group of adults initiated on ART Botswana national antiretroviral treatment program
Figure 2
Figure 2
Median (IQR) CD4+ Cell Count Increase From ART initiation
Figure 3
Figure 3
Percentage (95%CI) With Plasma HIV-1 RNA ≤400 copies/mL
Figure 4
Figure 4
Survival Estimate for Death or Viral Failure
See this image and copyright information in PMC

References

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