Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery

Tilak, Amod and Shenoy, Smita and Varma, Muralidhar and Kamath, Asha and Saravu, Kavitha (2019) Opportunistic infection at the start of antiretroviral therapy and baseline CD4+ count less than 50 cells/mm3 are associated with poor immunological recovery. Journal of Basic and Clinical Physiology and Pharmacology, 30 (2). pp. 163-171. ISSN 0792-6855

[img] PDF
RMS - 00006774.pdf - Published Version
Restricted to Registered users only

Download (216kB) | Request a copy

Abstract

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 tertiarycare 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.

Item Type: Article
Uncontrolled Keywords: Adherence; AIDS; CD4+ cell count; India; outcomes; tenofovir treatment.
Subjects: Departments at MU > Statistics
Medicine > KMC Manipal > Medicine
Medicine > KMC Manipal > Pharmacology
Depositing User: KMC Library
Date Deposited: 21 Jun 2019 11:41
Last Modified: 21 Jun 2019 11:41
URI: http://eprints.manipal.edu/id/eprint/154024

Actions (login required)

View Item View Item