Drug side effects and retention on HIV treatment: a prospective cohort study assessing the implementation of Tenofovir in South Africa and Zambia

With its recommendations that all patients initiate Tenofovir, WHO anticipated improved adherence and reduced lost to follow-up, with implications for long health outcomes such as CD4 recovery, viral suppression and survival. We show that the guideline change replacing Stavudine with Tenofovir in first-line ART improved retention in care and reduced single-drug substitutions.