Effectiveness and tolerability of nevirapine, stavudine, and lamivudine in clinical practice

Abstract

Background: Recent studies reveal patients on protease inhibitor (PI)-based regimens achieve viral suppression less often in clinical practice than in clinical trials. Nonnucleoside reverse transcriptase inhibitors (NNRTIs) can provide an equally effective and more convenient alternative. Purpose: This retrospective chart review examines the effectiveness, tolerability, and convenience of a nevirapine (NVP), stavudine (d4T), and lamivudine (3TC)-containing regimen in an urban HIV clinical practice. Method: Chart review of patients from September 1996 to April 2000 yielded 73 patients on NVP+d4T+3TC; 83.6% were treatment experienced. Results: By 16 weeks, 86.4% (57/66) had viral loads (VL) <400 in an as-treated (AT) analysis, while 78.1% (57/73) had VL <400 in an intent-to-treat (ITT) analysis. By 24 weeks, 84.6% (33/39) had VL <50 (AT). Beyond 48 weeks, 88.9% (16/18) had VL <50. The mean CD4 increase was 170 cells/mm3. Rash was the most common adverse event (13.7%) in this review. Conclusion: Consistent with other studies, this NVP+d4T+3TC regimen appears effective in both treatment-experienced and -naive patients, regardless of baseline viral loads, in a clinical practice setting.