Table 1.
Reasons for discontinuation of standard first-line ART regimen
| Reason for discontinuation of standard first-line ART (d4T/3TC/NVP) a |
Number of patients (male/female) | Proportion of total cohort of 1434 patients (%) |
|---|---|---|
| Toxicity | 28 (17/11) | 1.95% |
| • Nevirapine - rash (unknown WHO grade) | 1 (0/1) | 0.07% |
| • Nevirapine - rash (WHO grade II) | 5 (3/2) | 0.35% |
| • Nevirapine - rash (WHO grade III) | 4 (2/2) | 0.28% |
| • Nevirapine - Stevens-Johnson syndrome (WHO grade IV) b | 5 (4/1) | 0.35% |
| • Nevirapine - hepatitis (WHO grade IV) c | 2 (2/0) | 0.14% |
| • Nevirapine - total | 17 (11/6) | 1.19% |
| • Stavudine - pancreatitis (WHO grade III) | 3 (2/1) | 0.21% |
| • Stavudine - pancreatitis (WHO grade IV) | 2 (1/1) | 0.14% |
| • Stavudine - lactic acidosis (unknown WHO grade) | 1 (1/0) | 0.07% |
| • Stavudine - lactic acidosis (WHO grade III) | 3(1/2) | 0.21% |
| • Stavudine - peripheral neuropathy (unknown WHO grade) | 1 (0/1) | 0.07% |
| • Stavudine toxicity - peripheral neuropathy (WHO grade III) | 1 (1/0) | 0.07% |
| • Stavudine - total | 11 (6/5) | 0.76% |
| First-line failure d | 22 (16/6) | 1.53% |
| Other e | 4 (3/1) | 0.28% |
aToxicity grading per 2006 WHO guidelines (I-mild, II-moderate, III-severe, IV-severe, potentially life-threatening).
bOne patient died from drug-induced SJS.
cOne patient had a negative Hepatitis B surface antigen test documented. Serologies for other viral hepatitides are not available in Malawi. Neither patient was on concurrent TB treatment.
dAll patients in our cohort had confirmed virologic failure on first-line ART.
eFour Kaposi's sarcoma patients had been placed on a protease inhibitor-based regimen for possible antiangiogenic effects.