Publication:

Profile of highly active antiretroviral therapy failure human immunodeficiency virus patients at a tertiary health care centre of India: a success story of NACP

Background Although HAART has successfully controlled the progression of HIV and helped to prevent the disease significantly, new challenges are heading up and ART failure despite of good adherence is becoming a major hurdle in the way of HIV control. Considering these facts present study was planned with an objective to study clinical and immunological profile of antiretroviral therapy failure HIV patients.

Methods This observational study was conducted at ART plus centre of one of the tertiary health care centre of India from February 2018 to September 2019. Patients satisfying inclusion and exclusion criteria were interviewed by using semi-structured questionnaire and were examined and investigated for any opportunistic infections and their CD4 counts were studied.

Results Among total 4098 patients alive on ART at present study centre 90.6% were responding well to the 1st line of ART, while 8.7% had failed to 1st line of ART but responding well to the 2nd line whereas 0.7% had failed to 2nd line and were initiated on 3rd line of ART. Failure of ART was the cause for change in regimen among 84.9% of patients. Median of rise in CD4 count at 6 months from switch to 2nd line was 137 cells/mm3.

Conclusions Antiretroviral therapy has significantly improved outcome of the disease. Failure of ART is the major cause for change in ART regimen. Majority of patients in failure had WHO clinical stage 1 and 2.