|dc.description.abstract||Acquired Immunodeficiency Syndrome (AIDS) is characterized by the progressive
destruction of a person’s immune system and is the latest and most serious stage of Human
Immunodeficiency Virus (HIV) infection. Botswana currently has the highest estimated
prevalence of HIV infection in the world. Botswana has a relatively young population
structure, with about 60% of the approximately 1,8 million people aged less than 45 years.
HIV prevalence for pregnant women aged 15–45 years in Botswana did, however, decrease
marginally from 36,2% in 2001 to 35,4% in 2002. It is estimated that about 258 000
Botswana are now living with HIV and AIDS, and high morbidity and mortality rates due to
HIV/AIDS have seen Botswana slip down the United Nations Development Plan (UNDP)
Human Development Index rankings from 71 in 1996, to 122 in 1999/2000. In 2002
Botswana initiated public antiretroviral therapy (ART) at four sites initially to provide
treatment to HIV/AIDS patients before expanding the programme to the rest of the country.
The specific objective of the study was to investigate the prescribing patterns of ARV drugs
at Sekgoma Memorial Hospital ARV therapy clinic (SMH–IDCC) in the central district of
Botswana for a two–year period from 2005 to 2006.
Data from 1717 patients were obtained from the SMH–IDCC electronic database regarding
ARV drugs prescribed during the study period, CD4–Tcell count (cells/?L) at the
commencement of therapy and after six months from the commencement of therapy and
side effects necessitating change of therapy for the study period 2005 until 2006.
The study showed that there were eight antiretroviral therapy (ART) regimens prescribed:
zidovudine plus lamivudine plus efavirenz (AZT/3TC/EFV), zidovudine plus lamivudine plus
nevirapine (AZT/3TC/NVP), Combivir® plus efavirenz (CBV/EFV), Combivir® plus nelfinavir
(CBV/NFV), Combivir® plus nevirapine (CBV/NVP), stavudine plus lamivudine plus efavirenz
(D4T/3TC/EFV), stavudine plus lamivudine plus nelfinavir (D4T/3TC/NFV), and stavudine
plus lamivudine plus nevirapine (D4T/3TC/NVP).
The most prescribed ART regimen for adult patients was Combivir® plus efavirenz
(CBV/EFV) (51,37%). This was broken down as 17,20% of females and 34,17% of males. The second most prescribed ART regimen was Combivir® plus nevirapine (CBV/NVP)(36%
of the total study population (N=1717). This represented 34,17% of females and 1,98% of
The most prescribed ART regimen in children was zidovudine plus lamivudine plus efavirenz
(AZT/3TC/EFV) (3,73% of the total population), broken down as 1,05% of females and
2,68% of males. The second most prescribed regimen in this group was zidovudine plus
lamivudine plus nevirapine (ZDV/3TC/NVP) (3,50% of total population).
The findings from this study indicated that all eight the ART regimens prescribed at the study
site were in accordance with the Botswana national ART guidelines. There were thirteen
different types of side effects necessitating change of therapy, including pregnancy,
treatment failure and poor adherence. The average CD4–Tcell count change
(155.63 cells/?L, ± 204.08 cells/?L) for the study population was more than 100% after six
months from commencement of therapy, indicating success of therapy in terms of CD4–Tcell