Adherence, side effects and efficacy of stavudine plus lamivudine plus nelfinavir in treatment-experienced HIV-infected patients

Objectives: To evaluate adherence, side effects and efficacy of a modality of highly active antiretroviral therapy (HAART) in HIV-infected patients., Methods: In a cohort, prospective study, 65 previously treated patients rec eived stavudine plus lamivudine plus nelfi-navir. Fifty-three participants (81%) had a history of intravenous drug use. Patients were evaluated at 3-m onth intervals. The association of adherence with demographic variables, he patitis C virus infection, number of stopped antiretroviral regimens, HIV R NA level, CD4 cell count, and adverse effects to drugs was assessed. Results: After a median follow-up of 12 months, 30 participants (46%) showe d adequate adherence in all visits, An association was observed between adh erence and female sex: 18 of 47 men (35%) vs, 12 of 18 women (67%) presente d adequate adherence in all visits (P=0.0416), An association was also obse rved between adherence and low baseline HIV RNA level (P=0.0229). Discontin uation of treatment took place because of refusal to take medication in 11 participants (17%) and because of side effects in seven participants (11%), Undetectable HIV RNA level was achieved in 26 patients (40%) at 3 months a nd in lower percentages at months 6, 9 and 12, Conclusions: Overall adherence to the employed HAART regimen was poor. Fema le sex and low baseline HIV RNA were associated with better adherence. Refu sal to take medications and side effects were the main reasons to stop ther apy. At 3 months' follow-up, virological efficacy was achieved in 40% of pa tients. (C) 2000 The British Infection Society.