|
Background: Human Immunodeficiency Virus (HIV) remains a significant public health challenge globally, with India being home to the third-largest HIV epidemic in the world. The advent of antiretroviral therapy (ART) has markedly improved the prognosis of HIV-infected individuals. However, the effectiveness of ART is often compromised due to the development of drug resistance, necessitating a switch to second-line therapy. This study aims to assess the effectiveness of second-line ART in HIV patients who experienced first-line drug failure at KIMS Teaching Hospital, Koppal, India. Methodology: This institutional-based observational study involved 36 HIV patients (11 males and 25 females) aged 15 years and above, who had been on a second-line ART regimen for at least one year. Data were collected retrospectively from patients' medical charts, including socio-demographic information, clinical characteristics, and laboratory parameters. First-line ART regimens consisted of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI), while second-line ART included two NRTIs and one protease inhibitor (PI). Primary outcomes assessed were clinical, immunological, and virological responses. Statistical analyses were performed using SPSS software, with significance set at p<0.05. Results: The mean CD4 count increased from 150 cells/mm³ (±50) pre-treatment to 300 cells/mm³ (±100) post-treatment (p<0.001). The mean viral load decreased from 100,000 copies/mL (±50,000) to 10,000 copies/mL (±5,000) (p<0.001). Clinical failure occurred in 14% of patients, immunological failure in 17%, and virological failure in 11%. The loss to follow-up rate was 8%. No significant gender differences were observed in treatment outcomes. Conclusion: Second-line ART significantly improves immunological and virological outcomes in HIV patients who have failed first-line therapy. The findings support the continued use and expansion of second-line ART regimens to enhance health outcomes in similar settings. Further research is recommended to explore long-term outcomes and strategies to reduce treatment failure rates. |
Human Immunodeficiency Virus (HIV) remains a significant public health challenge globally, with India being home to the third-largest HIV epidemic in the world. According to the National AIDS Control Organization (NACO), there were approximately 2.3 million people living with HIV in India in 2021.1 The advent of antiretroviral therapy (ART) has markedly improved the prognosis of HIV-infected individuals by reducing viral load, improving immune function, and decreasing morbidity and mortality.2 However, the effectiveness of ART is often compromised due to the development of drug resistance, necessitating a switch to second-line therapy.
First-line ART typically comprises a combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI).3 Despite the success of this regimen, treatment failure due to factors such as poor adherence, drug toxicity, and the emergence of drug-resistant viral strains is not uncommon . Clinical, immunological, and virological failure criteria guide the transition to second-line ART, which generally includes two NRTIs and one protease inhibitor (PI).4
In the Indian context, the challenge of managing treatment failure is exacerbated by resource constraints, limited access to second-line drugs, and delayed diagnosis of treatment failure . Therefore, evaluating the effectiveness of second-line ART in patients who have failed first-line treatment is crucial to inform clinical practice and policy-making.5
This study aims to assess the effectiveness of second-line ART in HIV patients who experienced first-line drug failure at KIMS Teaching Hospital, Koppal, a tertiary care center in India. By analyzing demographic, clinical, and laboratory data, this research seeks to provide insights into treatment outcomes, thereby contributing to the optimization of HIV management strategies in similar settings.
Download PDF
Download PDF
Download PDF
Download PDF
+91 6901 460 112
+91 6901 460 112
editor@healthcare-bulletin.co.uk
Download XML
