title: A prospective study evaluating clinical outcomes and costs of three NNRTI-based HAART regimens in Kerala, India.
abstract: OBJECTIVE
  This prospective, observational, study evaluates the clinical outcomes, drug utilization patterns, and adherence to treatment of patients on highly active anti retroviral therapy (HAART) at a government institution in Kerala, India.
  
  
  METHODS
  Patients who met criteria for treatment of HIV/AIDS were enrolled into the study, given free NNRTI-based combination therapy, and were followed for a period of 6 months. Data regarding demographics, clinical outcome, laboratory results, drug utilization, adherence and adverse effects were collected. Analysis was conducted utilizing descriptive statistics, anova, Fisher-exact, andt-test.
  
  
  RESULTS
  One hundred and forty-two patients with HIV-1 were enrolled in the study into three treatment groups. The mean age was 37.88 years, 64% of the patients were male, and 92% were married. Group 1 was given zidovudine, lamivudine, and nevirapine [n = 52 (37%)], group 2 was given lamivudine, stavudine, and nevirapine [n = 51 (36%)], and group 3 was given lamivudine, stavudine, and efavirenz [n = 39 (27%)]. The increase in CD4 was 107.46 (SD: 106.25). Mean medication adherence for the 104 patients who completed the study, was 90.7%; for group 1: 92.06%, group 2: 93.37%1, and group 3: 85.71% (P > 0.05). Forty (38%) patients have at least one adverse event to HARRT, with headache being the most common side effect (11.5%). Mortality rate was 3.5% during the course of the study.
  
  
  CONCLUSIONS
  Provision of free NNRTI-based combination therapy to patients in Kerala, India, resulted in greater than 90% adherence leading to better clinical outcomes in terms of increasing CD4 counts and low mortality, for patients consistently attending a treatment clinic.
authors.affiliation: Masterskill College of Nursing & Health, Kualalumpur, Malaysia.
authors.forename: C
authors.initials: C
authors.lastname: George
authors.forename: A
authors.initials: A
authors.lastname: Yesoda
authors.forename: B
authors.initials: B
authors.lastname: Jayakumar
authors.forename: L
authors.initials: L
authors.lastname: Lal
mesh_terms: D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D048588:Benzoxazines / Q000191:economics / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D019259:Lamivudine / Q000191:economics / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence; D019829:Nevirapine / Q000191:economics / Q000627:therapeutic use; D011446:Prospective Studies; D018119:Stavudine / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome; D015215:Zidovudine / Q000191:economics / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine; D018119:Stavudine; C098320:efavirenz