Publication:

Evaluation of efficacy of two drug regimens of anti-retro viral therapy

Background CD4 count is an important marker to assess the effectiveness of treatment, mortality and survival rates in HIV patients on treatment. It is an important guide to treatment as it reflects drug resistance, treatment failure and need to switch over to different regimen. Objective of the study was to assess the efficacy of tenofovir (TDF) and efavirenz (EFV) versus zidovudine (AZT) and nevirapine (NVP), in combination with lamivudine (3TC) in HIV-infected patients taking basal and after treatment CD4 count levels as tools.

Methods A retrospective observational study on 40 adult HIV patients, receiving AZT+3TC+NPV (ZLN) (group I) and 18 patients on TDF+3TC+EFV (TLE) (group II) was carried out. Demographic profile, medication prescribed, baseline CD4 cell counts, serially monitored CD4 count values and Hb% were recorded from patient's medical record. Student’s paired ‘t’ test was done to compare CD4 counts before and after treatment in individual groups. Unpaired ‘t’ test was used for the comparison of CD4 counts between the groups.

Results A very highly significant (p<0.0001) increment in CD4 count was observed in group I after treatment. Improvement in CD4 count was highly significant in group II as well with p<0.0004. The extent of improvement was significantly better (p<0.05) in group I as compared to group II. Patients in group I were better staged clinically.

Conclusions We conclude that ART regimen containing AZT/3TC/NVP is proved to be superior to TDF/3TC/EFV. However further studies need to be done, by taking drug adherence into account in a larger patient population.