title: Once-a-day highly active antiretroviral therapy in treatment-naive HIV-1-infected adults in Senegal.
abstract: OBJECTIVE
  To study the effectiveness, adherence and tolerance of a once-a-day highly active antiretroviral therapy regimen in adults in Senegal.
  
  
  METHODS
  In a prospective, open-label one-arm study, 40 treatment-naive HIV-1-infected patients took the following three drugs once a day at bedtime: didanosine, lamivudine and efavirenz. The primary endpoint was the percentage of patients with plasma HIV-1 RNA below 500 copies/ml at 6 months. The analysis was done on an intent-to treat basis.
  
  
  RESULTS
  Eighty-five per cent of patients were at Centers for Disease Control and Prevention stage B or C and the plasma HIV RNA level was 5.4 +/- 0.4 log(10) copies/ml at baseline. The percentage of patients with plasma HIV-1 RNA below 500 copies/ml at 6 months was 95% [95% confidence interval (CI), 83-99]. The proportions of patients with plasma HIV-1 RNA below 50 copies/ml at months 3, 6, 9, 12 and 15 were 26% (n = 39; 95% CI, 12-39), 78% (n = 40; 95% CI, 65-90), 70% (n = 40; 95% CI, 56-84), 77% (n = 39; 95% CI, 64-90) and 69% (n = 39; 95% CI, 55-84), respectively. The CD4 cell count was 164 +/- 75 x 106/l at baseline and increased by a mean of 199 +/- 101 x 106/l at month 15. Permanent treatment discontinuation was never necessary for serious adverse effects. Adherence was excellent, as shown by plasma drug concentrations and according to the results of the questionnaire.
  
  
  CONCLUSIONS
  The once-daily regimen of didanosine, lamivudine and efavirenz was safe, easy-to-take and demonstrated strong antiretroviral and immunologic effects in African patients with advanced HIV infection.
authors.affiliation: Institut de Médecine et d'Epidémiologie Africaine, Bichat Claude Bernard Hospital, Paris, France.
authors.forename: Roland
authors.initials: R
authors.lastname: Landman
authors.forename: Ricarda
authors.initials: R
authors.lastname: Schiemann
authors.forename: Safiatou
authors.initials: S
authors.lastname: Thiam
authors.forename: Muriel
authors.initials: M
authors.lastname: Vray
authors.forename: Anna
authors.initials: A
authors.lastname: Canestri
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Coumba Toure
authors.initials: CT
authors.lastname: Kane
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
authors.forename: Papa Salif
authors.initials: PS
authors.lastname: Sow
authors.forename: Mame Awa
authors.initials: MA
authors.lastname: Faye
authors.forename: Mandoumbe
authors.initials: M
authors.lastname: Gueye
authors.forename: Gilles
authors.initials: G
authors.lastname: Peytavin
authors.forename: Cecile
authors.initials: C
authors.lastname: Dalban
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Ndoye
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome
chemical_list: D012367:RNA, Viral