ABSTRACT
Background: Acyclovir is considered to be an effective treatment for pityriasis rosea but randomized, blinded, placebo-controlled trials have not been performed. Aims: To test the efficacy of acyclovir in pityriasis rosea in a randomized, triple–blind, placebo-controlled trial. Methods: Twenty seven patients with pityriasis rosea were randomly allocated to receive placebo (n = 13) or acyclovir (800 mg fi ve times daily for one week) (n = 14). The severity of disease was assessed by the pityriasis rosea area and severity index. Cure was defi ned as the absence of erythema, with no or minimal scaling. Results: The number of days (mean ± standard deviation) taken for cure was not signifi cantly different between the two groups (placebo 26.54 ± 9.14 days versus acyclovir 33.29 ± 9.49 days; P = 0.0720, t-test; 95% confi dence interval of difference −0.65 to 14.14 days). Limitations: The sample size for the present study was calculated using data from an earlier study. As the standard deviation was not mentioned in that article, a common standard deviation of fi fteen days was assumed. A study with a larger sample size may be more effective in detecting minor treatment differences between acyclovir and placebo, if they exist at all. Conclusion: Acyclovir is not an effective treatment for pityriasis rosea.
ABSTRACT
Background & objectives: The National AIDS Control Organization (NACO) of India has been providing free ARV (antiretroviral) drugs since 2004. by 2012, 486,173 patients had received treatment through the antiretroviral therapy (ART) centres. The objective of this observational study was to assess the factors determining survival of patients on ART under routine programme conditions in an ART centre in north India five years after its inception. Methods: Treatment naive HIV positive patients who were enrolled in the ART centre between May 2009 and May 2010 and started on ART as per the Revised NACO guidelines 2009, were included in the study and outcome was assessed after two years of follow up. Results: A total of 1689 patients were included in the analysis, of whom 272 (16.10%) expired, 205 (12.13%) were lost to follow up (LFU), 526 (31.14%) were transferred out to other facilities and 686 (40.63%) were alive at the end of two years. Majority (92%) of the deaths occurred in the first six months of therapy. Age >30 yr, male gender, poor functional status, haemoglobin level <11 g/dl, body weight <45 kg and CD4 count <100/μl at baseline had significantly higher relative hazard of death. Most LFU also occurred in the first six months and these patients had significantly low CD4 count, weight, haemoglobin level and higher number of patients in Stages III and IV as compared to those who survived. Interpretation & conclusions: The study findings revealed poor survival in the first six months of therapy especially in those with severe immunosuppression. This emphasizes the need for early enrolment into the programme. The high LFU occurring early after initiation of therapy suggests the urgent need to build an efficient patient retrieval system in the programme.