“[Regimens of 25 men]

ABC/3TC/RTV/ATZ

ABC/3TC/EFV

ABC/3TC/AZT/RTV/LPV

TDF/3TC/EFV

ABC/3TC/TFV/RTV/ATZ

TDF/3TC/RTV/LPV

ABC/3TC/AZT/RTV/LPV

TDF/3TC/RTV/LPV

ABC/3TC/NVP

TDF/FTC/RTV/LPV

ABC/3TC/EFV

TDF/FTC/EFV

ABC/3TC/RTV/LPV

ABC/3TC/RTV/ATZ

TDF/FTC/EFV

TDF/3TC/EFV

ABC/3TC/RTV/ATZ

TDF/FTC/EFV

TDF/FTC/EFV

TDF/FTC/RTV/SQV

TDF/FTC/EFV

TDF/FTC/EFV

TDF/FTC/RTV/SQV

ABC/3TC/RTV/ATZ

TDF/FTC/NVP”

“The median time from HIV seroconversion to starting HAART was 1.6 years in 1996-1997 and 1.4, 1.8, 2.4, and 2.2 years in 1998-1999, 2000-2001, 2002-2003, and 2004-2006, respectively. After excluding time at risk when HAART would not be indicated, the proportion of person-time spent receiving HAART increased from 17% in 1996-1997 to 54%, 66%, 69%, and 73% in the same calendar periods, respectively. As expected, the use of nonnucleoside reverse transcriptase inhibitor (NNRTI)–based regimens increased over time and by 2004-2006, the proportion of person-time receiving NNRTI- based HAARTwas approximately equal to that spent receiving protease inhibitor (PI)–based HAART (40% an d 42% of person-time on HAART, respectively, compared with 18% and 71%, respectively, in 1998- 1999,when the first NNRTIs were available)…”

“AZT and 3TC were components in the initial antiretroviral strategy for most patients in all groups, with 3TC being used slightly less frequently among blacks compared with other racial/ethnic groups (78% vs. 85% to 86%). Nelfinavir was the most commonly prescribed PI (61%), followed by a ritonavir-boosted PI (26%), whereas efavirenz was prescribed for 63% and nevirapine for 37% of participants in the NNRTI category.”

“59% of the [Korean HIV patients] had a diagnosis of AIDS before HAART [i.e. 41% were started on AIDS drugs without AIDS being present, probably based on low CD4 cell counts]”

“After HAART was introduced in 1996, the prevalence of patients receiving this treatment gradually increased, surpassing 75% in 2002 to 2004.”

“Pharmaceutical companies from Kenya, India, South Africa and Europe are squaring up for a titanic battle for control of the Kenyan drug market. At the heart of the coming competition is an estimated Ksh10 billion (US$139 million) annual market for anti-retrovirals (ARVs) that will open up when Kenya moves to meet its target of providing the drugs to 120,000 HIV-positive people. The value of the emerging ARV market is estimated by assuming that each patient will use drugs worth Ksh6,500 ($90) per month, which works out to Ksh78,000 ($1,080) per year per patient. The ARV market will double the size of Kenya's drug market, which is currently estimated at over Ksh12 billion ($167 million). Currently, only an estimated 60,000 patients out of 150,000 are on ARVs…The growth in the drug industry has seen a rapid rise in the number of distributors, most of whom act as local representatives of major multinationals. Among the country's leading distributors are Phillips Pharmaceuticals, Lords Healthcare and Surgipharm.”

“Datamonitor expects [Roche's] Fuzeon to experience a compound annual growth rate (CAGR) of 11.8% between 2005 and 2010, and peak sales of $400m[illion] by 2010…The NRTI [nucleoside analog] class accounted for 55%, or $3.7 billion of sales value in 2004, making it the predominant and fastest growing antiretroviral class. This strong growth can be primarily attributed to two relatively new drugs – GSK’s [GlaxoSmithKline's] Trizivir (lamivudine/zidovudine/abacavir) and Gilead’s Viread (tenofovir), which generated $574m and $739m of sales in 2004 respectively. However, despite the impressive performance by these two drugs, the class leader remains the traditional therapeutic backbone – GSK’s Combivir, a FDC [fixed dose combination] of Retrovir (zidovudine [AZT]) and Epivir (lamivudine), commonly used in first-line therapy. Indeed, the product has witnessed steady growth since its launch in 1997, generating $914m of sales in 2004, representing an increase of 6.6% compared to 2003.”

“[From Table 4: Initial ART in 1988-1991 was Mono (100%) Dual (0) or Triple (0); in 1992-1995 was Mono (65%), Dual (33%), Triple (2%) and in 1996-2001 was Mono (38%), Dual (12%) or Triple (50%)]”

“In the 1999-2000 group, only 53% of the [US, HIV+] teens were on HAART drug therapy.”

“PI became widely available in France in late March 1996”

“The proportion of person-time spent on HAART increased from 0·5% in 1995 to 4·7%, 22%, 40%, 49%, 53%, and 57% in 1996, 1997, 1998, 1999, 2000, and 2001, respectively. Correspondingly, the proportion of person-time spent naive to antiretroviral therapy decreased from 63% in 1995 to 57%, 42%, 32%, 27%, 26%, and 25%, respectively. Person-time spent on non-HAART treatment fell from 26% in 1995 to 7% in 2001, with remaining person-time (7–11%) spent off treatment, having previously taken HAART or another antiretroviral regimen.”

“The Centre guidelines were revised in July 1997 to recommend triple combination therapy for all antiretroviral-naive individuals with plasma HIV-1 RNA levels greater than 5000 copies/ml or CD4 cell counts below 500 3 106 cells/l”

“In January 1996, only 1% of 83 active patients were taking HAART. This proportion increased to 52% on 1 January 1997, 69% on 1 January 1998, and 79% on 1 January 1999.”

“The use of monotherapy [AZT] steadily increased [from 1987] until 1993…Double combination therapy was first used [on children] in 1993…In 1998, triple combination therapy became the most common therapy [about 25% in 1997 and about 50% of children in 1998]”

“The use of antiretroviral therapy during the prenatal, intrapartum, and neonatal periods increased dramatically in 1994 after the report from the AIDS Clinical Trials Group Protocol 076 that a three-part regimen of zidovudine given to the mother before and during labor and delivery and to the infant after birth significantly reduced the risk of perinatal transmission of HIV-1. [Figure 3 shows a dramatic rise from about 5-20% in 1992 to almost 100% by 1995]”

“The proportion of patients for whom any antiretroviral therapy was prescribed increased, from 72 percent of patients in 1994 to 95 percent by June 1997, with marked increases in the prescription of combination regimens (from 25 percent in 1994 to 94 percent by June 1997). The most dramatic increases were in the rate of use of regimens containing protease inhibitors, from 2 percent in mid-1995 to 82 percent by June 1997.”

“Data on zidovudine use, clinical trial participation, and sociodemographic, clinical, and hematologic variables were collected every 6 months from 1,195 AIDS-free HIV-1-seropositive homosexual men from April 1987 to September 1989. Overall prevalence of zidovudine use rose from 3.6% in mid-1987 (visit 7) to 23% in mid-1989…In multivariate analyses, CD4+ lymphocyte number was the most consistent predictor of initiation of therapy over all four study visits.”