Long-term outcome of HIV-infected patients treated at a tertiary care hospital in southern India.

ABSTRACT

Background. In India, the data are scanty on long-term outcome of patients with HIV/AIDS treated with first-line antiretroviral therapy. Methods. We retrospectively studied the first 100 patients enrolled for antiretroviral therapy between February 2006 and March 2007 at Jawaharlal Institute of Postgraduate Medical Education and Research, a tertiary care hospital in southern India. Adherence, side-effects and clinical status were recorded at follow-up visits. The outcome measures were immunological recovery, attrition rate and first-line failure rate. First-line failure was defined on the basis of WHO clinical and immunological criteria. Results. The median age of the patients was 36 years. The median baseline CD4 count was 117 cells/cmm. After a median follow-up of 44 months, of the initial 100 patients, 41 patients continued to be on follow-up, 10 patients had died and 41 patients had been lost to follow-up. The attrition rate was 20 per 100 patient-years. Fifty-five patients received >6 months of antiretroviral therapy; of these, 36 patients continued to have good immunological status with a median CD4 count of 548 cells/cmm after a median follow-up of 62 months. The first-line failure rate was 6.12 per 100 patient-years. Conclusion. The initial loss of patients to follow-up is a matter of concern particularly when durable improvement in immunological status is achievable if patients with HIV/AIDS can continue to be on long-term antiretroviral therapy.