@article{fdi:010042508,
  title = {{T}olerability and effectiveness of first-line regimens combining {N}evirapine and lamivudine plus zidovudine or {S}tavudine in {C}ameroon},
  author = {{L}aurent, {C}hristian and {B}ourgeois, {A}nke and {M}poudi {N}gol{\'e}, {E}. and {C}iaffi, {L}. and {K}ouanfack, {C}. and {M}ougnutou, {R}. and {N}kou{\'e}, {N}. and {C}almy, {A}. and {K}oulla-{S}hiro, {S}. and {D}elaporte, {E}ric},
  editor = {},
  language = {{ENG}},
  abstract = {{W}e compared the tolerability and effectiveness of two major first-line regimens used in resource-limited settings, namely zidovudine-lamivudine-nevirapine and stavudine-lamivudine-nevirapine. {HIV}-1-infected adults in {C}ameroon were enrolled in a prospective cohort study between 2001 and 2003. {T}hey were eligible if they had {AIDS} or a {CD}4 cell count below 350/mm(3), a {K}arnofsky score over 50%, and no contraindications to antiretroviral treatment. {T}he patients were followed up to 2 years. {O}f 169 patients, 85 received zidovudine-lamivudine-nevirapine and 84 stavudine-lamivudine-nevirapine. {T}he incidence rates of treatment changes, death, drug resistance, and severe adverse effects were, respectively, 12.0 [ 95% confidence interval ({CI}) 7.2-19.9] and 10.9 ( {CI} 6.4-18.3) per 100 person-years; 5.7 ( {CI} 2.8-11.4) and 7.6 ( {CI} 4.2-13.7); 2.9 ( {CI} 1.1-7.7) and 5.0 ( {CI} 2.4-10.6); and 41.7 ( {CI} 30.2-57.6) and 49.1 ( {CI} 36.1-66.6). {T}he {K}aplan-{M}eier curves for the likelihood of remaining on the initial regimen ( p = 0.8) and for survival ( p = 0.5) did not differ significantly between the groups. {I}n {C}ox multivariate analysis only a lower baseline {CD}4 cell count was associated with death ( p < 0.001). {T}he proportion of patients with undetectable viral load and the increase in the {CD}4 cell count were similar in the two groups. {A}nemia was rare ( 4% vs. 6%). {F}ive cases of severe peripheral neuropathy and one case of lipodystrophy occurred. {T}his study suggests that the zidovudine-lamivudine-nevirapine combination is a safe first-line treatment, even in settings with few laboratory resources. {I}n view of stavudine toxicity, these results support recommendations calling for a gradual switch from stavudine- to zidovudine-based regimens.},
  keywords = {},
  booktitle = {},
  journal = {{A}ids {R}esearch and {H}uman {R}etroviruses},
  volume = {24},
  numero = {3},
  pages = {393--399},
  ISSN = {0889-2229},
  year = {2008},
  DOI = {10.1089/aid.2007.0219},
  URL = {https://www.documentation.ird.fr/hor/fdi:010042508},
}