Differences in CD4 response using nevirapine-based and efavirenz-based antiretroviral therapy in HIV-infected patients
Abstract
Purpose: Using nevirapine (NVP) and efavirenz (EFV) as the basis of antiretroviral therapy has the same clinical efficacy, but different virological efficacy. Both drugs are stated to be able to suppress the viral load and increase the CD4 count in HIV-infected patients, but it is not known which of the two drugs has a better immunological response to increase the CD4 count. This study compares the response of increased CD4 counts using NVP- and EFV-based antiretroviral therapy (ART) in HIV-infected patients.
Methods: Research with a retrospective cohort study design. Research data were obtained from the medical records of HIV-infected patients at RSUD Dr. Haji Moch. Ansari Saleh Banjarmasin, from December 2004 to January 2015. The patients analyzed met the established inclusion and exclusion criteria. An increase in CD4 count of ≥25% was measured.
Results: One hundred fifteen patients (115) met the inclusion and exclusion criteria, divided into 66 patients receiving NVP-based ART (47 patients experienced an increase in CD4 ≥25%, one patient died) and 49 patients receiving EFV-based ART (33 patients experienced an increase in CD4 ≥25%). The RR of NVP-based ART compared to EFV-based ARV is 1.08 (95% CI 0.85-1.38; p>0.05). The average increase in CD4 from baseline in each group was significantly different (p<0.05), but the comparison of the average absolute CD4 changes in both groups was not significantly different (p>0.05). The time required to increase CD4 count by ≥25% is 12 months after therapy using an NVP-based regimen (95% CI 6.62-17.38), and 11 months after treatment using an EFV-based regimen (95% CI 8.50-13.50). There is no significant difference in the time required to increase CD4 counts by ≥25% (p>0.05).
Conclusion: Both the use of NVP-based ART and EFV-based ART can significantly increase the CD4 count from baseline, but there is no significant difference in the average increase in CD4 count between the two ARV therapy groups.
