A STUDY OF PEOPLE LIVING WITH HIV-AIDS [PLHA] ON FIRST LINE HIGHLY ACTIVE ANTIRETROVIRAL THERAPY [HAART] WITH IMMUNOLOGICAL FAILURE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 56
Abstract
BACKGROUND Follow-up of patients with First line antiretroviral therapy, Cluster Differentiation (CD4) counts are done every 6 months. Viral load is not possible in resource poor settings like India. Non-Governmental Organisation (NGO’s), Human Immunodeficiency Virus (HIV) treating physicians and international guidelines recommend viral load as the follow-up method for first line failure, so to study the impact of national program with immunological criteria and its sensitivity to identify virological failure is needed at this juncture. METHODS A total of 170 patients from northern districts of Tamilnadu referred to Government Hospital for Thoracic Medicine (GHTMTambaram Sanatorium) State AIDS Clinical Expert Panel (SACEP) committee with suspected first line ART failure were included in the study [after fulfilling the inclusion and exclusion criteria]. Viral load done for these patients were compared with Immunological criteria for concordance or discordance. RESULTS In our study we conclude that Virological discordance was noted in 51% of all cases. CD4 falling greater than 50% of on treatment peak value has the highest sensitivity to detect virological failure. The ODD’s ratio for immunological criteria CD4 falling more than 50% was three times more than other criteria with significant P-value 0.002. Immunological criteria CD4 persistently below 100 had highest specificity. CONCLUSION Immunological criteria CD4 falling more than 50% had highest sensitivity. 2. Immunological criteria CD4 persistently below 100 had had highest specificity. 3. The ODD’s ratio for immunological criteria CD4 falling more than 50% of on treatment peak value was three times more than other criteria with significant P-value 0.002. 4. Immunological and virological discordance was 51% of all cases. 5. Differences in age and duration of ART was not associated with virological failure between males and females. 6. An economical lab test with low cost to detect the viral load is the need of the hour
Authors and Affiliations
Natarajan , Vijayanand , Ashokkumar , Ravichandran , Mohamed Muthalif, Namitha , Ramalingam , Marimuthu
Keywords
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- EP ID EP123366
- DOI 10.14260/jemds/2016/886
- Views 69
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