Comparision and evaluation of the clinical features of the patients of ART 1 failure who have started ART 2 medication

Abstract

Background: ART introduction was a breakthrough step and a boon for HIV infected and AIDS patients. Since the launch of world’s second largest ART programme by Indian Government on 1st April 2004, duration and quality of patient’s life has improved significantly. But after years of treatment with first line ART drugs clinical deterioration is being observed in several patients. This study was done to find out clinical symptoms present in treatment failure cases and to look for any improvement after one year of second line ART.Methods: This is a Single tertiary care teaching hospital based clinical (assessment with investigation) continuous longitudinal, prospective and retrospective, observational study at ART plus Centre, Kanpur. All patients on 1st line ART treatment in the centre were screened for treatment failure as decided by SACEP from 2016 to 2018. Treatment failure was suspected in patients on first line ART treatment with deterioration or non-improvement of clinical symptoms which was later confirmed by immunological and virological test.Results: Study included 71 (61%) female and 47 (39%) male patients. Heterogeneous mode of transmission of disease was most common (97 (82%)) followed by Blood transfusion (11 (9%)). HIV infection prevalence in age group of 30 to 40 years was 54 (45%). Most common clinical features of the patients with first line ART treatment failure were weight loss (105 patients), chronic diarrhoea (56 patients), fever (34 patients), and cough (24 patients). After treatment for one year with 2nd line ART drugs above symptoms were reduced to 20, 5, 5 and 12 patients respectively.Conclusions: First line ART failure was most common among female patients and heterogeneous mode of transmission was the commonest. Most common clinical features of first line ART failure were weight loss, chronic diarrhoea, fever, and cough which were reduced significantly after treatment with 2ndline ART drugs for one year.