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close this bookUganda Ministry of Health - UNAIDS HIV/AIDS Drug Access Initiative - Preliminary Report (UNAIDS, 2000, 14 p.)
View the document(introduction...)
View the documentIntroduction
View the documentPatient population
View the documentOutcome of patients accessing antiretroviral therapy
View the documentResistance to antiretroviral drugs
View the documentThe Cost of Antiretroviral Therapy
View the documentSummary
View the documentLessons learned and future directions

Summary

Initiation of therapy

· A total of 905 patients have accessed the UNAID drug access initiative

· Approximately equal numbers of men and women have begun ARV therapy

· Patients presented at an advanced stage of disease; 80% had CD4+ < 200 cells/mm3

· Approximately half of patients were started on 2NRTI and half on HAART; more recently, there has been an increase in the proportion of patients started on HAART

Response to therapy

· Among all patients started on ARVs to date, 58% are alive and remain in care.

· Kaplan-Meier analysis revealed that the probability of surviving and remaining in care was 48% at one year.

· Patients on both 2NRTI and HAART had virologic and immunologic response to therapy, indicating that antiretroviral therapy programs could be successfully implemented in this developing country setting.

· Patients were often started on 2NRTI due to financial constraints. Although those on 2NRTI demonstrated virologic and immunologic improvement, those on HAART had a greater and more sustained response to therapy.

· Resistance to 3TC was common. Markers for antiretroviral drug resistance in Uganda were found to be similar to those of subtype B viruses in the U.S. and Europe, suggesting that similar methods for monitoring resistance can be used in Uganda.