Published May 31, 2023 | Version https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article79.pdf
Journal article Open

To Evaluate the Outcome of Second Line Anti-Retroviral Therapy in HIV Positive Patients at Tertiary Care Centre

Authors/Creators

  • 1. Resident Doctor, JLN Medical College, Ajmer, Rajasthan
  • 2. Associate Professor, JLN Medical College, Ajmer, Rajasthan
  • 3. Senior Professor, JLN Medical College, Ajmer, Rajasthan
  • 4. Assistant Professor, JLN Medical College, Ajmer, Rajasthan

Description

Background: Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources it is important to optimize the timing of second-line ART initiation and use the most effective compounds available. Methods: This prospective study was carried out at a tertiary care hospital among HIV-infected patients who was failed on first-line treatment and started on second-line HAART during October 2020 to September 2021 and formed the cases of the study and registered at ART centre, Ajmer. Ethical approval was obtained from the Institutional Ethics Committee of this institution. Result: In our study at baseline of 2nd line ART initiation mean CD4 cell count was 299.04 cells/ul ; at 6 months of 2nd line ART therapy mean CD4 cell count was 334.24 cells/ul and at 12 months mean CD4 cell count was 396.82 cells/ul. Change in CD 4 count from 6 months to baseline was 35.20 (P value 0.001) and change in CD 4 count from 12 months to baseline was 97.78(P value 0.001). The mean CD4 cell count is found to be increased from baseline to successive follow-ups. The increase in CD4 count is statistically significant (P value <0.05) at 6 and 12 months from baseline. Conclusion: Second line ART was found to achieve statistically significant (P value <0.05) clinical effectiveness (weight increase), virological effectiveness (viral load decrease), immunological effectiveness (CD4 count increase) at 6 and 12 months from baseline.

 

 

 

Abstract (English)

Background: Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources it is important to optimize the timing of second-line ART initiation and use the most effective compounds available. Methods: This prospective study was carried out at a tertiary care hospital among HIV-infected patients who was failed on first-line treatment and started on second-line HAART during October 2020 to September 2021 and formed the cases of the study and registered at ART centre, Ajmer. Ethical approval was obtained from the Institutional Ethics Committee of this institution. Result: In our study at baseline of 2nd line ART initiation mean CD4 cell count was 299.04 cells/ul ; at 6 months of 2nd line ART therapy mean CD4 cell count was 334.24 cells/ul and at 12 months mean CD4 cell count was 396.82 cells/ul. Change in CD 4 count from 6 months to baseline was 35.20 (P value 0.001) and change in CD 4 count from 12 months to baseline was 97.78(P value 0.001). The mean CD4 cell count is found to be increased from baseline to successive follow-ups. The increase in CD4 count is statistically significant (P value <0.05) at 6 and 12 months from baseline. Conclusion: Second line ART was found to achieve statistically significant (P value <0.05) clinical effectiveness (weight increase), virological effectiveness (viral load decrease), immunological effectiveness (CD4 count increase) at 6 and 12 months from baseline.

 

 

 

Files

IJPCR,Vol15,Issue5,Article79.pdf

Files (344.3 kB)

Name Size Download all
md5:7b600ff828176f6bc90122a8d15c4079
344.3 kB Preview Download

Additional details

Identifiers

URL
https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article79.pdf

Dates

Accepted
2023-05-08

Software

Repository URL
https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article79.pdf
Development Status
Active

References

  • 1. Federal Ministry of Health (FMOH) Ethiopia Ethiopian national comprehensive HIV care guideline 2018.pdf. 2018. 2. Stephanie Watson and Carmelita Swiner. The History of HIV Treatment: Antiretroviral Therapy and More. August 03, 2022. 3. Cheney L, Barbaro JM, Berman JW. Antiretroviral Drugs Impact Autophagy with Toxic Outcomes. Cells. 2021; 10(4):909. 4. Zhao Y, Mu W, Harwell J, Zhou H, Sun X, Cheng Y, et al. Drug resistance profiles among HIV-1-infected children experiencing delayed switch and 12- month efficacy after using second-line antiretroviral therapy: an observational cohort study in rural China. J Acquir Immune Defic Syndr 2011; 58:47–53. 5. Win, M. M., Maek-A-Nantawat, W., Phonrat, B., Kiertiburanakul, S., & Sungkanuparph, S. Virologic and immunologic outcomes of the secondline regimens of antiretroviral therapy among HIV-infected patients in Thailand. Journal of the International Association of Physicians in AIDS Care 2011; (Chicago, Ill.: 2002), 10(1), 57– 63. 6. Murphy RA, Sunpath H, Castilla C, Ebrahim S, Court R, Nguyen H, Kuritzkes D, Marconi VC, Nachega JB. Second-line antiretroviral therapy: long-term outcomes in South Africa. J Acquir Immune Defic Syndr. 2012 Oct 1;61(2):158-163. 7. Tripathi A, Youmans E, Gibson JJ, et al. The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study. AIDS Res Hum Retroviruses. 2011; 27:751–758. 8. Yehia BR, French B, Fleishman JA, et al. Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4. J Acquir Immune DeficSyndr. 2014; 65:333–339 9. Marks G, Patel U, Stirratt MJ, Mugavero MJ, Mathews WC, Giordano TP, Crepaz N, Gardner LI, Grossman C, Davila J, Sullivan M, Rose CE, OʼDaniels C, Rodriguez A, Wawrzyniak AJ, Golden MR, Dhanireddy S, Ellison J, Drainoni ML, Metsch LR, Cachay ER. Single Viral Load Measurements Overestimate Stable Viral Suppression Among HIV Patients in Care: Clinical and Public Health Implications. J Acquir Immune Defic Syndr. 2016 Oct 1;73(2):205-12 10. Ajose O, Mookerjee S, Mills EJ, Boulle A, Ford N. Treatment outcomes of patients on second-line antiretroviral therapy in resource-limited settings: a systematic review and meta-analysis. AIDS. 2012 May 15;26(8):929-38. 11. Berdi F., Abderrahim B., Jihane I., Yassine A., Hicham E., Kamal D., & Yassir B. Les interactions médicamenteuses chez des patients sous chimiothérapie: Étude réalisée au service d'hématologie clinique de HMIMV-RABAT. Journal of Medical Research and Health Sciences, 2023; 6(4): 2519–2526. Retrieved from http:// jmrhs.info/index.php/jmrhs/article/vie w/686.