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First-line antiretroviral (ARV) drug regimens used in Vietnam
What are the first-line antiretroviral (ARV) drug regimens used in Vietnam?

The first-line antiretroviral (ARV) drug regimens used in Vietnam are listed in the table below:

 

d4T + 3TC + NVP

30mg + 150mg + 200mg twice a day (NVP 200mg daily first 2 weeks)

Preferred regimen

Do not use NVP if ALT > 2,5 x normal limit.

If patient is taking rifampicin, switch NVP to EFV if possible.

d4T + 3TC + EFV

30mg + 150mg twice a day + 600mg once a day

Indicated:

Patients with NVP allergy (grade I & II) or hepatoxicity

Patients taking rifampicin

Contraindicated:

Patients with severe NVP allergy (grade III and IV)

Pregnant women

Patients with history of depression or psychosis

AZT + 3TC + NVP

300mg + 150mg + 200mg twice a day (NVP 200mg daily 1st 2weeks)

Indicated:

Patients not tolerant to D4T (allergy, pancreatitis, peripheral neuropathy, lipoatrophy)

Check HgB before starting. Do not use if HgB < 7g/L.

AZT + 3TC + EFV

300mg + 150mg twice a day + 600mg once a day

Indicated:

Patients not tolerant to D4T (allergy, pancreatitis, peripheral neuropathy, lipoatrophy)

Check HgB before starting. Do not use if HgB < 7g/L.

 

Stavudine (d4T), lamivudine (3TC), and nevirapine (NVP) is the most commonly prescribed combination. In patients who are allergic to NVP or develop hepatotoxicity, EFV is substituted. Zidovudine (AZT) is used instead of d4T in these regimens in patients who are intolerant to d4T. d4T, 3TC, NVP, and AZT can be taken with or without food; EFV should be taken on an empty stomach preferably before bed. For these medications to be effective, it is important for patients to be consistent from day to day as to the time that these medications are taken and to avoid missing doses.

More information on specific ARV medications can be found in the Vietnam Ministry of Health Guidelines for HIV/AIDS Treatment.

By Howard Libman, M.D.

Preferred language

(Information not available in Vietnamese will be shown in English)

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