A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India
Background: The tenofovir–lamivudine–efavirenz regimen was introduced in 2018, and there was a lack of data on the treatment trends in human immunodeficiency virus (HIV) patients in India. Therefore, we initiated this study. Objectives: Our objective was to evaluate the clinical and immunolog...
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| Language: | English |
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Wolters Kluwer Medknow Publications
2024-07-01
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| Series: | MGM Journal of Medical Sciences |
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| Online Access: | https://journals.lww.com/mgmj/fulltext/2024/11030/a_study_on_clinico_immunologic_response_and.13.aspx |
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| author | Madhuchhanda Mandal Sabnam Parvin Sonali Das |
| author_facet | Madhuchhanda Mandal Sabnam Parvin Sonali Das |
| author_sort | Madhuchhanda Mandal |
| collection | DOAJ |
| description | Background:
The tenofovir–lamivudine–efavirenz regimen was introduced in 2018, and there was a lack of data on the treatment trends in human immunodeficiency virus (HIV) patients in India. Therefore, we initiated this study.
Objectives:
Our objective was to evaluate the clinical and immunological response to antiretroviral therapy (ART), as well as the virological suppression rate in antiretroviral-naïve HIV-positive patients attending the School of Tropical Medicine in Kolkata, West Bengal, India.
Settings and Design:
This longitudinal prospective study was conducted at the School of Tropical Medicine in Kolkata from July 2019 to May 2020.
Materials and Methods:
A total of 106 treatment-naïve HIV-infected patients were recruited and evaluated for clinical, immunological, and virological responses over 6 months following the initiation of ART.
Statistical analysis:
All statistical calculations were performed using R software version 4.0.2. Comparisons between observations were made using the t test, and statistical associations were assessed with Fisher’s exact test.
Results:
All patients were diagnosed with HIV-1 infection, and the mean time to ART initiation was 12.9 days, with a standard deviation of 8.6 days. Among the participants, 75 patients (70.8%) had at least one opportunistic infection (OI), the most common being oral candidiasis, followed by extrapulmonary tuberculosis. Additionally, 59 patients (55.7%) had multiple OIs. The majority of the study population (77.4%) presented with advanced HIV disease. Six patients (5.7%) developed immune reconstitution inflammatory syndrome during the 6-month follow-up period. At baseline, most patients had a CD4 count between 150 and 200 cells/μL, and after 6 months of follow-up, most had a CD4 count above 300 cells/μL. Viral suppression was achieved in 97.1% of patients. Excluding those with poor adherence, the efficacy of the tenofovir–lamivudine–efavirenz regimen in suppressing HIV viral load was 99%.
Conclusion:
This study concludes that there was a significant improvement in clinical and immunological responses, as well as virological suppression, following the initiation of ART in ART-naïve HIV-positive patients at 6 months follow-up. |
| format | Article |
| id | doaj-art-f59751f7e05142779fd2ece2cdf2f320 |
| institution | Kabale University |
| issn | 2347-7962 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | MGM Journal of Medical Sciences |
| spelling | doaj-art-f59751f7e05142779fd2ece2cdf2f3202024-11-09T09:36:00ZengWolters Kluwer Medknow PublicationsMGM Journal of Medical Sciences2347-79622024-07-0111347247810.4103/mgmj.mgmj_118_24A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern IndiaMadhuchhanda MandalSabnam ParvinSonali DasBackground: The tenofovir–lamivudine–efavirenz regimen was introduced in 2018, and there was a lack of data on the treatment trends in human immunodeficiency virus (HIV) patients in India. Therefore, we initiated this study. Objectives: Our objective was to evaluate the clinical and immunological response to antiretroviral therapy (ART), as well as the virological suppression rate in antiretroviral-naïve HIV-positive patients attending the School of Tropical Medicine in Kolkata, West Bengal, India. Settings and Design: This longitudinal prospective study was conducted at the School of Tropical Medicine in Kolkata from July 2019 to May 2020. Materials and Methods: A total of 106 treatment-naïve HIV-infected patients were recruited and evaluated for clinical, immunological, and virological responses over 6 months following the initiation of ART. Statistical analysis: All statistical calculations were performed using R software version 4.0.2. Comparisons between observations were made using the t test, and statistical associations were assessed with Fisher’s exact test. Results: All patients were diagnosed with HIV-1 infection, and the mean time to ART initiation was 12.9 days, with a standard deviation of 8.6 days. Among the participants, 75 patients (70.8%) had at least one opportunistic infection (OI), the most common being oral candidiasis, followed by extrapulmonary tuberculosis. Additionally, 59 patients (55.7%) had multiple OIs. The majority of the study population (77.4%) presented with advanced HIV disease. Six patients (5.7%) developed immune reconstitution inflammatory syndrome during the 6-month follow-up period. At baseline, most patients had a CD4 count between 150 and 200 cells/μL, and after 6 months of follow-up, most had a CD4 count above 300 cells/μL. Viral suppression was achieved in 97.1% of patients. Excluding those with poor adherence, the efficacy of the tenofovir–lamivudine–efavirenz regimen in suppressing HIV viral load was 99%. Conclusion: This study concludes that there was a significant improvement in clinical and immunological responses, as well as virological suppression, following the initiation of ART in ART-naïve HIV-positive patients at 6 months follow-up.https://journals.lww.com/mgmj/fulltext/2024/11030/a_study_on_clinico_immunologic_response_and.13.aspxantiretroviral therapy; hiv infection; opportunistic infections; tenofovir-lamivudine-efavirenz; tuberculosis |
| spellingShingle | Madhuchhanda Mandal Sabnam Parvin Sonali Das A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India MGM Journal of Medical Sciences antiretroviral therapy; hiv infection; opportunistic infections; tenofovir-lamivudine-efavirenz; tuberculosis |
| title | A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India |
| title_full | A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India |
| title_fullStr | A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India |
| title_full_unstemmed | A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India |
| title_short | A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India |
| title_sort | study on clinico immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naive hiv positive patients at a tertiary care hospital in eastern india |
| topic | antiretroviral therapy; hiv infection; opportunistic infections; tenofovir-lamivudine-efavirenz; tuberculosis |
| url | https://journals.lww.com/mgmj/fulltext/2024/11030/a_study_on_clinico_immunologic_response_and.13.aspx |
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