Long Term Outcome of Adult Patients on Antiretroviral Therapy (ART) in India

Abstract

We report the data analysis of 10 years (2005-2015) of follow up of an antiretroviral therapy (ART) centre in Mumbai (India) treating adult patients (age >18 years) working under corporation sector funded by national AIDS control organization (NACO). In the duration of study, total registered Human Immunodeficiency Virus (HIV) positive patients were 18554. Five thousand three hundred patients were lost to follow up and 1393 patients were transferred out to other ART centre. Thus only 11861 patients were evaluable. Male: female: transgender ratio was 1.92: 1: 0.015. HIV- 1 patients were 18474 and HIV- 2 patients were 80. ART was offered to the 6138 eligible patients. Out of these 4581 patients are alive and on ART. Total deaths were 942. One hundred and sixty patients required alternative ART while another 175 patients were put on second line ART. At a median follow up of 5 years overall survival was 92% and adherence was 86%. The percentage of patients having documented opportunistic infections was as follows: candidiasis 35%, tuberculosis 23%, bacterial respiratory infections 15%, bacterial skin infections 14%, cryptosporidiosis 9%, Herpes simplex 7%, Herpes zoster 6%, pneumocystis jirovaci 5%, cryptococcal meningitis 2%, toxoplasmosis 2%, and micosporidiasis 1%, cytomegalovirus retinitis 0.5%. Most common dose limiting side effects of the ART were Zidovudin induced anemia (15%), Stavudine induced neuropathy and lip dystrophy (18% each) and efavirenz induced disorientation (8%) and they required substitution of drugs. Two percent patients were referred for second line ART (Switch regimen). The incidence of multidrug resistant kochs was 1.3%.