Treatment Outcomes for HIV Patients on Three HAART Regimens in South East Nigeria: A Comparative Study

Abstract

Human Immunodeficiency Virus (HIV) attacks the body's immune system and is responsible for a major public health problem. Highly Active Anti-Retroviral Therapy (HAART) is key to its management. This study aimed at evaluating and comparing the clinical and virological outcomes of three HAART regimens-TLD, TLE and TL/LPV/r. Number of participants was 330 patients (110 in each group). Data were analysed and compared between groups. A 5-parameter scoring system was used to compare the performance of the regimens. Overall mean age was 44.7 (±10.7) years. Normal BMI 138 (41.8%), overweight (33.3%), obese (20.9%) and underweight (3.9%). Normal hemoglobin level, 194 (58.8%). Mean baseline CD4 count was 389.9 ± 293.7. Adherence to TLD (90.0%), TLE (89.1%), TL/LPVr (62.7%). TLD group showed the most clinical improvement with the most patients in stage 1 after one year, 108 (99.1%). Viral suppression at 6 months for TLD (86.4%), TLE (86.4%), TL/LPVr (50.0%) and at 12 months, TLD (90.0%), TLE (91.8%), TL/LPVr (88.2%). The difference in viral suppression between the TLD/TLE and TL/LPVr groups was statistically significant (p < 0.001). Factors associated with WHO clinical stage 1 at 6 months were age ≥35 years with TLD and female sex for TLE; and with viral suppression at 6 months were good adherence with TLD and TL/LPVr and female sex with TLE. For all patients collectively, good adherence was significantly associated with viral suppression at 6 months and 1 year. Predictor of WHO stage 1 at 6 months was female sex, OR 0.483 (95% CI 0.238-0.980). For predictors of viral suppression at 6 months, good adherence had the highest odds ratio, OR 6.911 (95% CI 3.768-12.676), being currently married OR 1.826 (95% CI 1.036-3.217). TLD performed best with a score of 14, TLE 13, TL/LPVr 5, out of a maximum score of 15.