BACKGROUND: In India, the data are scanty on long-term outcome of patients with HIV/AIDS treated with first-line antiretroviral therapy. METHODS: We retrospectively studied the first 100 patients enrolled for antiretroviral therapy between February 2006 and March 2007 at Jawaharlal Institute of Postgraduate Medical Education and Research, a tertiary care hospital in southern India. Adherence, side-effects and clinical status were recorded at follow-up visits. The outcome measures were immunological recovery, attrition rate and first-line failure rate. First-line failure was defined on the basis of WHO clinical and immunological criteria. RESULTS: The median age of the patients was 36 years. The median baseline CD4 count was 117 cells/cmm. After a median follow-up of 44 months, of the initial 100 patients, 41 patients continued to be on follow-up, 10 patients had died and 41 patients had been lost to follow-up. The attrition rate was 20 per 100 patient-years. Fifty-five patients received >6 months of antiretroviral therapy; of these, 36 patients continued to have good immunological status with a median CD4 count of 548 cells/cmm after a median follow-up of 62 months. The first-line failure rate was 6.12 per 100 patient-years. CONCLUSION: The initial loss of patients to follow-up is a matter of concern particularly when durable improvement in immunological status is achievable if patients with HIV/AIDS can continue to be on long-term antiretroviral therapy. Copyright 2014, NMJI.
BACKGROUND: In India, the data are scanty on long-term outcome of patients with HIV/AIDS treated with first-line antiretroviral therapy. METHODS: We retrospectively studied the first 100 patients enrolled for antiretroviral therapy between February 2006 and March 2007 at Jawaharlal Institute of Postgraduate Medical Education and Research, a tertiary care hospital in southern India. Adherence, side-effects and clinical status were recorded at follow-up visits. The outcome measures were immunological recovery, attrition rate and first-line failure rate. First-line failure was defined on the basis of WHO clinical and immunological criteria. RESULTS: The median age of the patients was 36 years. The median baseline CD4 count was 117 cells/cmm. After a median follow-up of 44 months, of the initial 100 patients, 41 patients continued to be on follow-up, 10 patients had died and 41 patients had been lost to follow-up. The attrition rate was 20 per 100 patient-years. Fifty-five patients received >6 months of antiretroviral therapy; of these, 36 patients continued to have good immunological status with a median CD4 count of 548 cells/cmm after a median follow-up of 62 months. The first-line failure rate was 6.12 per 100 patient-years. CONCLUSION: The initial loss of patients to follow-up is a matter of concern particularly when durable improvement in immunological status is achievable if patients with HIV/AIDS can continue to be on long-term antiretroviral therapy. Copyright 2014, NMJI.
Authors: Maria L Ekstrand; Elsa Heylen; Matilda Pereira; Jacob D'Souza; Shoba Nair; Amanda Mazur; Ranjani Shamsundar; B N Ravi Kumar; Sara Chandy Journal: AIDS Behav Date: 2020-07