Study Of Clinical, Immunological And Virological Profile Of People Living With Human Immunodeficiency Virus on Third Line Highly Active Anti Retroviral Therapy”

Abstract

BACKGROUND AND OBJECTIVES: HIV continues to be a major global public health issue. Highly active Antiretroviral therapy is the keystone of management of patients with HIV infection, requiring lifelong therapy with HAART.Poor adherence and drug resistance leads to failure of therapy in PLHIV.  This study aims at evaluating the outcomes with respect to clinical, immunological and virolological recovery in PLHIV on third line HAART.

METHODS: It is a prospective study conducted in Hospitals attached to Bangalore Medical College and Research Institute consisting of 100 patients of PLHIV who were initiated on Third line ART according to NACO guidelines .They were followed up for period of one year. Various factors like demographic details, clinical staging, immunological recovery and viral load were noted and analysed.

RESULTS: Out of 100 patients included  in study 60% were males and 40%were females. Mean age of the study population was 42.08 years. Mean duration from initiation of ART to start of third line was 8.4 year. There was good immunological response to third line ART, evident by rise in median CD4 cells count from 121.5cells/mm³ at start of 3rd line ART to 437 cells/mm³ by end of study. 78(78%) patients attained CD4 count of more than 200cells/mm³ by end of 12 months follow up. Median viral load at the start of 3^rd line ART was 86830copies/ml. By the end of 12 months follow up 77(77%) patients had VL suppressed to below 150copies/ml and majority of patients(76%) had become WHO clinical stage T1. Mortality in our group was 9 (9%) patients and 3 (3%) patients were loss for follow up at the end of study.

CONCLUSION: There was significant improvement in clinical staging, CD4 count and fall in viral load after initiation of third line ART . No major adverse effects were noted to third line ART.