Treatment Outcomes of Patients Receiving Combination Antiretroviral Therapy under the National Acquired...

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.

This was an record-based retrospective analysis of data of patients who were put on ART from January 2009 to December 2009.

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).

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.