LBF11/1 - THE BOTSWANA NATIONAL ARV TREATMENT PROGRAM: ONE YEAR OUTCOME OF THE FIRST 176 PATIENTS IN RURAL MAUN

9^TH EUROPEAN AIDS CONFERENCE (EACS)
1^st EACS RESISTANCE & PHARMACOLOGY WORKSHOP

October 25 - 29, 2003 Warsaw, Poland

19.2 Models of Treatment and Care in Diverse Settings

LBF11/1 - THE BOTSWANA NATIONAL ARV TREATMENT PROGRAM: ONE YEAR OUTCOME OF THE FIRST 176 PATIENTS IN RURAL MAUN

* Mudiayi T.K.¹, Beltz E.¹, Perenboom R.M.², Claessen F.A.P.², Darkoh E.³

(1) Maun General Hospital, Maun, Botswana² Department of Medicine, VU Medical Centre, MB Amsterdam, The Netherlands³ National ARV program, Gabarone, Botswana, Acknowledgments to PN Mazonde, MD., Director of Health Services, Ministery of Health, Gabarone, Botswana and ACHAP (collaboration between the government of Botswana, the Bill and Melinda Gates Foundation, Merck and Co Inc, and the Merck Company Foundation)

Background of Study: In 2002 Botswana, in cooperation with ACHAP (African Comprehensive HIV/AIDS Partnership), launched its national ARV program for HIV-infected Batswana. Maun General Hospital (MGH) is one of the 4 ARV treatment centers opened in the first year.

Objectives: to report the results of one year HAART in Maun.

Methods: Retrospectively records of all patients who started ART in MGH between July 7th and October 31st 2002 were reviewed till July 7th 2003. Criteria to start ART were: CD4+ cells < 200 /μl or symptomatic HIV infection.

Results: 176 patients were enrolled, 156 patients had ART for ≥3 months and are presented. At start 60% were female; 4% were < 10 years, 85% 20-50 years; 81.4% ART-naïve; 2.5 % asymptomatic, 75% had >10% weight loss, mean CD4 count was 169/μl . 74% started with Combivir plus efavirenz or nevirapine (women of childbearing age), according to Botswana Guidelines. Mean CD4+ cells increase was 297/μl (n=109); in 84% of 98 patients with available results viral load dropped <400 copies/ml; 9 % experienced serious adverse effects; TB treatment (n=9) or non-adherence (n=11) caused cessation of ART; 9 % had ≥1 treatment change, mainly due to adverse effects; 12% were at work (again); bodyweight increased in 61%; 23% died, 75% of them within 3 months.

Conclusions: ART in a district hospital in rural setting in Botswana is feasible. Many patients started in late-stage HIV infection. Results are comparable with routine practice in western settings.

Presenting Author: MD TK Mudiayi, Maun General Hospital, po box 12, pob 12, PO Box 12 Maun, Botswana, Phone: 267-660444/5/6 or 31-204444307

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