Ganesh Shanmugasundaram Anusuya, Chandrasekar Chockalingam, Manoharan Gurusamy, Patrick Nadol, Raja Krishnaraj and Ezhil Radhakrishnan
Introduction: We studied the prevalence and associated factors for various immunologic and virologic responses to second line antiretroviral therapy (SLA) in patients enrolled in a government tertiary care hospital in Chennai , India Methods: A cross-sectional study of human immunodeficiency virus patients who have failed first line antiretroviral therapy and subsequently initiated on SLA .Concordant favourable response (CFR) or (CD4+/VL+) was defined as: increase in CD4 count of >=50 cells/mL and achievement of plasma viral load<400 copies/mL after 6 months. Concordant unfavourable response (CUR) or (CD4-/VL-) defined as increase in CD4 count of <50 cells/mL and achievement of plasma viral load>400 copies/mL. Various clinical and demographic factors were analyzed between different response groups using Chi-Square test, t-test, and One way ANOVA Results: From January 2008 to February 2009, 60 patients initiated on SLA. In those 76.7% experienced CD4+/ VL+, 10% CD4+/VL-, 5% CD4-/VL+ and 8.3% CD4-/VL- response. The characteristics of CFR and CUR groups were: 97.8% and 100% males (p- value>0.05), mean baseline CD4 count of 100 and 198 cells/mL (p-value<0.05), mean baseline viral load of 187754 and 265580 copies/mL (p- value>0.05), mean CD4 count at 6 months (313 vs. 147 cells/mL; p-value<0.05), adherence>95% (100% vs. 40%; p-value<0.05). Immunologic only response (CD4+/VL-) was associated with sub optimal adherence. Conclusion: 76.7% of patients after 6 months on SLA indicated CFR and 8.3% experienced CUR. CUR associated with poor adherence.
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