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.