Management of antiretroviral therapy (ART) in Albania

Purpose of the study

To describe some features of ART management in Albania, as a limited resource country with low prevalence of HIV infection, and compare with concurrent European approach.

Methods

In the study are included 73 adult cases who are receiving ART at Infectious Diseases (ID) Service in Tirana, Albania, till May 2008. Since 2004 provision of ART started for the first time in Albania. Therapy is delivered for all patients in one center at ID Service in the capital, Tirana.

Summary of results

There are 45 male and 28 female HIV patients under therapy. Resistance testing, HLA B 5701 screening testing and Pap smear screening testing are not available as part of the initial assessment of the patient. Criteria for initiation of therapy include symptomatic patient and CD4 <200. Most used first-line combinations are: ZDV/3TC + EFV in 40 adult patients and d4T + 3TC + EFV in 14 adult patients. The preferred back-bone nucleotide combination is AZT + 3TC. NNRTI-based initial regimen is preferred, with EFV as the most preferred drug. The only PI drug available in Albania is LPV/r which is used in six patients for the second-line therapy in combination with TNF and ddI.

Conclusion

Albania, as a country with low prevalence and limited resources, is using a public health ART strategy. We think that a better (if possible) strategy for ART management in Albania would be a combination of public health and individual approach.