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

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 2^nd Line ART Guidelines; enrolled and followed up for initiation of 2^nd Line ART at our institute.

Results

Provision of Free 2^nd 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 1^st Line ART Failure patients were referred to SACEP Clinic, Table 1.

Table 1

Discussion

Switching to 2^nd 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 2^nd Line ART helps quite in reduction of PVL. Deaths analysis shows that late switch to 2^nd Line ART at CD4 < 100 cells/mm³ may not result in desired therapeutic goals.