Soon after 6 months of Art, when compared to TDF, the hazard of substitution was ten (ninety five% CI: five.88) for d4T and 4.4 (ninety five% CI: 2.5, 7.eight) for AZT. The adjust between the 1st 6 months and 6 to 24 months was significant (p for effect modification ,.001). Intercourse, age, HIV RNA at Art initiation, WHO medical stage at Art initiation, and Artwork initiation calendar year ended up all related with solitary agent substitution in the multivariable examination (Table two). NNRTI agent was associated with hazard of solitary-drug substitution in the multivariable analysis, but there was no interaction among NNRTI agent and NRTI. Nor ended up there interactions 
among NRTI and either sex or age in predicting single drug substitution. When restricting to workplace internet sites for a sensitivity investigation, the altered hazard ratio in comparison to TDF, was 13.eight The distribution of patients with over 12 months of CD4 data for inclusion in evaluating CD4 change was seventy four% of TDF recipients, 62% of d4T recipients, and 73% of AZT recipients. In mixed linear regression, with NRTI agent as the only set effect, NRTI agent was significantly related with CD4 boost with an annual increase for TDF, d4T, and AZT of sixty seven. (ninety five% CI: 61.two, seventy two.8), seventy nine.2 (ninety five% CI: seventy six.9, 81.6), and 53.1 (95% CI: forty nine.2, fifty six.nine) cells/mm3/12 months, respectively (p,.001 Desk four). In adjusted multivariable examination, in which we incorporated time current HIV RNA suppression and sex as modifiers to the slope together with intercourse, age, HIV RNA at Artwork initiation, and NNRTI as terms in the intercept, a considerable affiliation was managed. For time details with HIV RNA suppression, the improve in CD4 rely was 83.9 (ninety five% CI: 78., 90.) for TDF, 83. (ninety five% CI: 80., 86.) for d4T, and 73. cells/mm3/yr (95% CI: 68., 76.six) for AZT (p,.001). In a sensitivity analysis, when proscribing to office websites, we continued to notice a statistically substantial association among NRTI agent and CD4 slope (p,.001) with a slope for TDF of eighty five.3 (ninety five% CI: 78.4, ninety two.three), for d4T of ninety. (95% CI: 77.6, 102.3), and for AZT of 69. (ninety five% CI: 62.5, 75.four) cells/mm3/12 months. In the community system, the affiliation was no more time statistically important (p = .three): TDF, 65.two (95% CI: forty two.six, 87.7) d4T, 82.seven (ninety five% CI: seventy nine.three, 86.1) and AZT, 78.four (seventy one.six, eighty five.six).Determine 1. Movement diagram commencing with the total quantity of individuals in the Artwork administration cohort, motives for exclusion, and ultimate sample for this study.Throughout the 24 month comply with-up period of time, the charge for loss-fromcare purchase Tenofovir (Disoproxil) appeared equivalent for TDF (nine.eight for every one hundred PYRs ninety five% CI: 4.223.) 19447622and AZT (9.five per 100 PYRs ninety five% CI: 4.eleven.7) and was maximum for patients on d4T (eleven.eight for every 100 PYRs ninety five% CI: 5.127.five).