Context:Several studies have reported metabolic abnormalities in patients taking protease inhibitor (PI) based therapy from several parts of the world. But there is no prospective study in India after switching from PI sparing regimen to PI based regimen.Aims:To assess whether North-East Indian Human Immunodeficiency Virus (HIV) patients also develop similar metabolic abnormalities to PI.Settings and Design:This prospective study was conducted in Anti-retroviral therapy (ART) Centre of Excellence, at a tertiary care Medical Institute.Materials and Methods:Fifty-five patients taking PI based ART were taken for the study. These patients were started on Ritonavir based therapy, after treatment with first line drugs had failed according to National AIDS Control Organization (NACO) guidelines 2008. Glucose and lipid profiles were evaluated. American Diabetes Association (ADA) and NCEP ATP III criteria were used to categorize glucose and lipid abnormalities. International Diabetes Federation (IDF) 2006 cut-off was used for waist circumference and blood pressure.Statistical Analysis Used:Paired t-test was done whenever applicable.Results:There was a significant increase in waist circumference after 6 months of 2nd line ART from 78.0 cm to 80.2 cm (P value < 0.001). There was significant increase in both systolic and diastolic blood pressure after 6 months. In 29.8% of patients blood pressure rose to hypertensive level after 6 months. Total cholesterol, triglyceride and low density lipoprotein cholesterol also rose significantly after 6 months but not high density lipoprotein cholesterol.Conclusions:Our study showed that North-Eastern Indian patients also develop metabolic abnormalities to protease inhibitors similar to people of other races.

BACKGROUND HIV-HCV co-infection is common in Manipur because of the increase in number of intravenous drug users (IDUs) and being eastern border state of India. HIV-HCV patients die of liver complications in spite of highly active antiretroviral therapy (HAART). The aim of the present study is to compare the clinico-immunological response to highly active antiretroviral therapy in HIV and HIV-HCV co-infection in Manipur. MATERIALS AND METHODS The present study was conducted in 45 HIV mono-infected (Group-I) and 45 HIV-HCV co-infected (Group-II) patients who were on first line antiretroviral treatment (ART). RESULTS In the present study, the clinico-immunological (CD4) response to ART in both the groups was recorded. The commonest route of transmission is heterosexual (62.2% and 53.3%) activity followed by IDUs (31% and 37%). The trend of CD4 is almost coinciding at initial 188.86± 104.27 Vs. 179.00 ± 98.19 cells/mm 3 but mean CD4 for HIV group is higher at 6 th month, at 12 th month and at 18 th month with 502.82± 272.22 Vs. 412.47± 229.48 cells/mm 3 after ART as compared to HIV-HCV group significantly P<0.05 (P=0.032). Further, the CD4 response was better in HIV-HCV with treatment of both HIV and HCV than without HCV treatment. CONCLUSION The present study showed that the immunological response to ART to both HIV and HIV-HCV co-infection groups is good, but better in HIV group. Further, amongst the HIV-HCV co-infection the immunological response was better to those who had undergone HCV treatment. So routine screening for HCV in HIV infected patients and starting HCV treatment early will result in better quality of life.

No abstract