A Study of Outcomes in Patients on Anti Retroviral Therapy (ART) at a Tertiary Care Hospital

CD4 count is an indicator of immune status used as the eligibility criterion for the initiation of antiretroviral therapy (ART) and the monitoring of immunological response to ART in HIV infected patients in resource limited settings.

To describe the demographic characteristics, immunological profile and immunological response to the first line ART regimens at a tertiary care centre in Goa, India

Observational study

Anti Retroviral therapy centre at a tertiary care hospital in Goa, India.

741 patients enrolled and receiving ART from 1st April 2005 to 31st March 2008.

Data of the 741 participants was collected using a structured anonymous interview schedule.

Number and percentages, Paired t test, Log rank test, Chi square test, Kaplan-Meier survival analysis.

As of March 2008 741 were recruited for ART. The median age of the patients was 36yr (Inter Quartile Range: (31.5–42), 507 (68.4%) were males with a sex ratio of 462 females per 1000 males. The overall CD4-cell count (cells/mm3) at ART initiation was 149 cells/?l which increased significantly at 6,12,18 months and 24 months. The mortality was found to be 21.3% at the end of the study period, deaths being maximum in first 6 months. There were no significant differences in CD4-cell counts increase by sexes, age group and ART regimen.

Clinical, immunologic and virologic outcomes at large in HIV/AIDS care clinics in resource poor settings are poorly described beyond the first year of highly active antiretroviral treatment (HAART). In this setting, patients on first-line triple combination antiretroviral therapy (ART) showed significant improvements in CD4-cell status but adherence level was good. Early mortality rate was high, indicating a need for early interventions.