Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery.
| Autor: | Tilak, Amod, Shenoy, Smita, Varma, Muralidhar, Kamath, Asha, Tripathy, Amruta, Sori, Ravi, Saravu, Kavitha |
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| Předmět: |
DRUG therapy for AIDS
ANTIRETROVIRAL agents MORTALITY of AIDS patients CONVALESCENCE PATIENT aftercare MEDICAL records CD4 antigen LOGISTIC regression analysis AIDS-related opportunistic infections TREATMENT effectiveness HIV seroconversion DATA analysis software DESCRIPTIVE statistics TERTIARY care |
| Zdroj: | Journal of Basic & Clinical Physiology & Pharmacology; Mar2019, Vol. 30 Issue 2, p163-171, 9p |
| Abstrakt: | Introduction: There is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital. Methods: After approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant. Results: ART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4+ cell count was 65 (39, 98) cells/mm3 and 160 (95, 245) cells/mm3. The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4+ count <50 cells/mm3 were associated with poor immunological recovery. Conclusions: With long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings. [ABSTRACT FROM AUTHOR] |
| Databáze: | Supplemental Index |
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