Evaluation of Anti-Retroviral Combination Therapy In Patients With HIV/Aids Injecting Drug Users

Abstract

HIV stands for ‘Human Immunodeficiency Virus’. HIV is a retrovirus that infects cells of the human immune system (mainly CD4), and destroys or impairs their function. This viral infection results in a constant decrease in human immune system and eventually results in immunodeficiency. Indonesia is one of the countries that show increasing number of HIV/AIDS cases. By June 2011, 26.483 cumulative HIV/AIDS cases were reported in Indonesia. Drug users are a major factor in the spread of HIV/AIDS infections. Antiretroviral (ARV) therapy in patients with HIV infection aims at suppressing replication in a maximum way for a long period, restoring and maintaining the body’s immune. It is important to extend and improve the quality of life to reduce the morbidity and mortality. Efficacy of the combination of three of antiretroviral drugs was better than the combination of two types of antiretroviral, where there is a decrease in viral load to undetectable level and increased CD4 lymphocyte count. This study was conducted compare several combinations of antiretroviral, that is Lamivudine +Zidovudine+ Nevirapine, Lamivudine+ Zidovudine +Efavirenz, Lamivudine +Stavudine +Nevirapine and Lamivudine+Stavudine+Efavirenz, in terms of effectiveness, side effects, adherence and antiretroviral drug costs in patients HIV/AIDS drug users in Drug Dependence Hospital Jakarta. The study was conducted in a retrospective way, using data obtained from medical records of patients from January 2005 to December 2010 in patients with CD4 ≤ 350 cells/mmɜ and a minimum of 6-12 months of antiretroviral treatment. Of the 333 patients, 100 patients had antiretroviral treatment and met the inclusion criteria. The results showed effectiveness of combination antiretroviral therapy in that there was an increase in the number of CD4; the increase was found to be different in each antiretroviral combination. However, statistical test with ANOVA showed that the increases in CD4 had no significant difference. Nausea is a common side effect in HIV/AIDS patients who received antiretroviral therapy. Of the 100 patients, 94% adhered to the therapy and the combination of Lamivudine+Zidovudine +Efavirenz required the highest cost, compared to the other combinations.