Treatment Outcomes of Patients Receiving Combination Antiretroviral Therapy under the National Acquired Immunodeficiency Syndrome Control Programme.

Abstract

Introduction:The free antiretroviral therapy (ART) initiative of the Government of India was launched on April 1, 2004, since then it is being scaled up in a phased manner. The aim of this study was to analyze the treatment outcome of patients receiving first-line ART through the National Acquired Immunodeficiency Syndrome Control Programme of India.Materials and Methods:This was an record-based retrospective analysis of data of patients who were put on ART from January 2009 to December 2009.Results:Of the 548 patients (63.87% males; median age of 37 years), 55% of patients were employed and majority of them have low monthly income. Patients showed a significant improvement in clinical and functional status after staring ART therapy, as percentage of patients in clinical Stage 1 increased significantly (from 35.5% to 90.3%) and that of Stage 3 and 4 decreased drastically. Ninety percent of patients were working, and none was bedridden after 2 years of ART. Patients with >95% adherence to ART showed more improvement than those with <95% adherence (40% patients). The median increase in cluster of differentiation 4 (CD4) count was 134 cells/mm3 at 6 months, 185 cells/mm3 at 12 months, and 255 cells/mm3 at 24 months. Majority of patients died in clinical staging 4 with CD4 cell count <50 cells/mm3. Over 2 year's period, 20% patients died and 9.31% were lost to follow-ups (LFUs).Conclusion:Early detection, timely treatment, and long-term adherence are the keys for the success of ART programme in India; it is of utmost importance to do intense Information Education Communication/Behavioral Change Communication, regular monitoring, up-to-date record keeping, tracking of LFUs, and triangulation and data analysis for timely action and for consolidation of success made so far.