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Our experience in second line Anti Retroviral Therapy (ART) At State Aids Clinical Expert Panel (SACEP) Clinic, Centre of Excellence (CoE), Art Centre, B. J. Medical College, Civil Hospital, Ahmedabad

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Retrovirology20107 (Suppl 1) :P53

https://doi.org/10.1186/1742-4690-7-S1-P53

  • Published:

Keywords

  • Infectious Disease
  • Cancer Research
  • Treatment Failure
  • Line Treatment
  • State AIDS

Background

To share our experience in second line Anti Retroviral Therapy (ART) at State AIDS Clinical Expert Panel (SACEP) Clinic, Centre of Excellence (CoE), ART Centre, B. J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.

Methods

First line treatment failure Patients (as per Indian National ART Guidelines) were referred to SACEP Clinic for further evaluation and if eligible as per Indian National 2nd Line ART Guidelines; enrolled and followed up for initiation of 2nd Line ART at our institute.

Results

Provision of Free 2nd Line ART to People Living with HIV/AIDS (PLHA) Program by National AIDS Control Organization (NACO), India was started in November, 2008 under SACEP Clinic for Gujarat and Rajasthan PLHAs. Till October 2009 total 127 1st Line ART Failure patients were referred to SACEP Clinic, Table 1.

Table 1

Parameter

Outcome

Total Patients referred to SACEP

127

Patients Eligible and referred for Plasma Viral Load (PVL) (n = 127)

122(96.06%)

Patients recommended 2nd Line ART after PVL (n = 122)

75(61.47%)

Patients initiated Free 2nd Line ART (n = 75)

69(92.0%)

Patients under follow up TB Treatment/Counseling to initiate 2nd Line ART

6

Adherence Counseling for 2nd Line ART Patients (n = 69)

69(100%)

Undetectable PVL (<400 copies/ml) after 6 months of 2nd Line ART (n = 28)

24

Therapeutic Success according to Undetectable PVL (24/28)

85.74%

No. of Death after initiation of 2nd Line ART (n = 69)

8(11.59%)

Death Analysis

Cause of Death

WHO Stage/PVL/CD4

n = 8

 

Accidental

T3/560459/17

1

 

Renal Failure

T3/208048/230

1

 

Malignancy

T4/384469/38

1

 

Opportunistic Infections (OIs)

T3/46453/67

4

  

T4/507495/26

 
  

T4/1166325/32

 
  

T4/289375/21

 
 

Unknown Reason

T3/4095718/29

1

Discussion

Switching to 2nd Line ART based on Immunological Failure, Clinical Failure is not recommended; as out of 122 PLHAs analyzed only 75 PLHAs have Virological Failure. Adherence Counseling for 2nd Line ART helps quite in reduction of PVL. Deaths analysis shows that late switch to 2nd Line ART at CD4 < 100 cells/mm3 may not result in desired therapeutic goals.

Authors’ Affiliations

(1)
ART center B J Medical College, Ahmedabad, India

Copyright

© Mankad et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.

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