Antiretroviral drugs in the treatment of people living with human immunodeficiency virus: experience in a south Indian tertiary referral centre.

ABSTRACT

OBJECTIVE: A decrease in the number of new acquired immunodeficiency syndrome (AIDS) cases and AIDS--related deaths was seen in developed countries since 1996 due to the use of new combination of antiretroviral drugs. This retrospective study discusses the use of antiretroviral drugs in the treatment of people living with human immunodeficiency virus (HIV) in a developing country setting. METHODS: A retrospective case note analysis was done of patients receiving antiretroviral therapy at YRG Centre for AIDS Research and Education between Aug. 1996 and Feb. 1999. Out of 936 persons with HIV treated at this centre, 6.1% of the patients were prescribed three groups of drugs Group A was the combination of the reverse transcriptase inhibitors (nRTI) zidovudine 600 mg daily and lamivudine 300 mg daily, Group B was the combination of zidovudine 600 mg daily, lamivudine 300 mg daily with protease inhibitor (PI) ritonavir 1200 mg daily and Group C was the combination of zidovudine 600 mg daily and lamivudine 300 mg daily with indinavir 2400 mg daily. Twenty HIV positive pregnant women were given zidovudine 500 mg daily during the third trimester (Group D) to reduce the vertical transmission of HIV. RESULTS: The mean CD4 gain was 188.0 cells/micro litre in Group A, 118.8 cell/microlitre in Group B and 223.3 cells/microlitre in Group C with a mean duration of 4.3, 3.1 and 3.5 months respectively. Many patients stopped antiretroviral drugs due to high cost of therapy. CONCLUSION: Hence, physicians should prescribe antiretroviral drugs only after ensuring that the patients can afford and will comply with a longterm treatment. Prescribing guidelines should be available to those working in this field and should be adhered to so that emergence of resistant strains could be prevented.