Generic fixed dose combination
stavudine (
d4T),
lamivudine (3TC) and
nevirapine (NVP), named
GPO-VIR is recommended in the HIV treatment guidelines for Thailand. The long term effectiveness and adverse effects of this
drug combination for the treatment of HIV were evaluated in an ambispective study at Bamrasnaradura
Infectious Diseases Institute, Nonthaburi Province, Thailand from March 2002 to January 2006. A total of 152 adult treatment naive HIV patients who had received at least 12 months of
GPO-VIR were enrolled. The median (IQR) CD4 cell count increased from 23 (8-94) cells/microl at baseline to 126 (38-180), 136 (98-189), 199 (141-255) and 334 (243-414) cells/microl at 3, 6, 12 and 24 months (p < 0.001), respectively. The median (IQR) percentage of
body weights increased from baseline by 3.0% (0.3-6.3), 6.2% (2.2-9.3), 7.3% (3.9-10.9) and 8.1% (3.4-11.9) at 3, 6, 12 and 24 months, respectively and then remained at a plateau until the end of the 3-year study. The occurrence of new
opportunistic infections decreased significantly (p < 0.001) with
GPO-VIR treatment. Drug resistance occurred in 5 cases (3.3%) with a median (IQR) time of 18.0 (16.5-32.5) months to occurrence. Adverse effects included
hypercholesterolemia (43.2%),
lipodystrophy (35.5%),
hypertriglyceridemia (25%),
hypertension (13.1%),
peripheral neuropathy (11.9%),
hyperlactatemia (2.6%) and
lactic acidosis (1.3%). Thirty-six patients (27%) switched from
GPO-VIR to other anti-retroviral drugs regimens due to
lipodystrophy. This study showed
GPO-VIR had clinical and immunological benefits, but one-third of patients had adverse effects.