Comparative study of adverse effect profile of first line drugs Zidovudine (ZDV) + Lamivudine (3TC) + Nevirapine (NVP) Vs Tenofovir (TDF) + Lamivudine (3TC) + Atazanavir (ATV) + Ritonovir (RTV) in HIV/AIDS patients

Savithri Desai, Sankar Kurli, Harinika G.


Background: The biggest threat to mankind from the health perspective is probably the virus Human Immunodeficiency Virus (HIV) responsible for a serious disease known as Acquired Immune Deficiency Syndrome (AIDS). To compare the adverse effect profile of two antiretroviral regimens i.e, Zidovudine (ZDV) + Lamivudine (3TC) + Nevirapine (NVP) [regimen A] Vs Tenofovir (TDF) + Lamivudine (3TC) + Atazanavir(ATV) + Ritonavir (RTV) [regimen B] by clinical and biochemical methods.

Methods: This prospective, observational study was carried out in 200 HIV positive patients receiving first line and second-line antiretroviral therapy (ART) at ART centre, GGH, Vijayawada. Out of 200 patients, 100 patients received regimen A [(ZDV) + (3TC) + (NVP)] and 100 patients were treated with regimen B [(TDF) + (3TC) + (ATV) + (RTV)]. The collected data has been analysed and presented.

Results: Out of 200 patients, 110 patients developed ADRs. In this 110, 38 patients received regimen A and 18 patients received regimen B and had CD4 + count <250 cells/mm3. In the remaining 54 patients, 20 patients received regimen A and 34 patients received regimen B who had CD4+ count >250 cells/ mm3.

Conclusions: The ADRs were most common in those patients whose CD4+ count is less than 250cells/cu mm. Though the patients on second line showed significant increase in CD4+count, number of patients with ADRs were also more with regimen B. Though atazanavir containing regimen is more efficacious than zidovudine containing regimen, but regimen B produces more serious adverse effects. So, second line drugs are reserved for treatment failures to first line, drug resistance and for those not tolerating first line drugs.


AIDS, ADRs, HIV, Atazanavir, ART

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