Relationship between combination antiretroviral therapy regimens and diabetes mellitus-related comorbidities among HIV patients in Gaborone Botswana

Table 4 Standard First and Second Line ART Regimens in Botswana: Composition of cART lines

First line	First line Modifications	Second line	Second line Modifications
AZT +3TC (CBV-combivir) + EFV AZT + 3TC + NVP AZT + DDI+ EFV AZT+ DDI + NVP	TDF renal toxicity w/o CVD risk: ABC/3TC/DTG (If CVD rash: Consult HIV specialist) CNS Toxicity and/or Hepatic Toxicity: TRU/DTG	TDF + FTC + ALU	AZT Anemia and/or TDF Renal Toxicity: ABC/3TC/DTG
TDF+ FTC (or 3TC) + EFV TDF+ FTC (or 3TC) + NVP		CBV + ALU	If anemic ABC+ 3TC+ ALU
D4T + 3TC + EFV D4T + 3TC + NVP DDI +3TC + EFV DDI+ 3TC + NVP		TDF + FTC = ALU	If renal insufficiency but no anemia: CBV + ALU If renal insufficiency and anemia: ABC + 3TC + ALU

Third line regimen was made up of other alternative combinations or salvage therapy. This was deployed in case of failure of both the standard first and second-line regimens
The Botswana National ART programme also called Masa was launched in 2002. Over the years the Ministry of health and wellness has issued and updated ARV treatment guidelines based on WHO recommendations. First line and second line regimens have therefore been modified over the years from 2002 to 2016. Between 2002 and 2015, the period for this study, the treatment regimens were as presented in Appendix adapted from the 2012 and before 2016 treatment guidelines [9,10,11,12]

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