Impact of Anti Retro Viral (ART) Therapy on Clinical and Laboratory Parameters: A Longitudinal Study

Authors

  • Misha Gorantla Malla Reddy Medical College for Women, Hyderabad, Telangana
  • Anant Takalkar Maharashtra Institute of Medical Sci-ence and Research, Latur
  • Nagaraj Kondagunta Kamineni Institute of Medical Sciences, Telangana

Keywords:

ART, HIV, Ante-Retroviral Terapy, CD4, BML, Anemia

Abstract

Introduction- India is among the list of countries with highest HIV prevalence. Adequate viral suppression requires strict adherence to antiretroviral therapy (ART).Telangana ranks 7th in the prevalence of HIV in India

Objectives: The research was conducted to study the prevalence poor adherence among the study group and to study the effect of poor adherence on clinical and laboratory deterioration.

Methodology-This is an observational follow up (longitudinal) study done on 142 patients which includes all newly diagnosed (diagnosed on or after 1st January 2012), sero positive, adult patients, enrolled at ART centre Nalgonda and started on treatment during the months of December 2012, January 2013, February 2013, using a pre designed, pre tested questionnaire. They were visited one year after ART initiation and their clinical and laboratory parameters were studied.

Results-After one year 129 patients remained, of which 49.61% patients had good adherence and 50.39% patients had poor adherence. Decrease in BMI, worsening of HIV grade, presence of opportunistic infections were significantly present among patients with poor adherence. Low CD4 count and severe anaemia were also significantly associated with poor adherence.

Conclusion- There is significant worsening of clinical and laboratory parameters in patients with poor adherence.

References

WHO, Global Update On HIV Treatment 2015 - Results, Impact and Opportunities, World Health Organisation, 20 Avenue Appia, 1211 Geneva 27, Switzerland, www.who./int/hiv/publications/en/. (Accessed February 3rd, 2017)

UNAIDS, Prevention Gap Report, July 2016. Available online thttp://www.unaids.org/en/resources/documents /2016/prevention-gap(Accessed March9th, 2017)

National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India. Available online at http://naco.gov.in/nacp (Accessed May 3rd, 2017)

Hogg RS, Heath K, Bangsberg D, Yip B, Press N, O'Shaugh-nessy MV, et al. Intermittent use of triple-combination ther-apy is predictive of mortality at baseline and after 1 year of followup. AIDS 2002; 16:1051-8.

HIV cases decline in Telangana, AP. Hans India report. available at http://www.thehansindia.com/posts/index/ Andhra-Pradesh/2016-07-23/HIV-cases-decline-in-Telan gana-AP/244062 ( Accessed march 1st, 2017)

Adherence to HIV Treatment Regimens: Recommendations for Best Practices. [Online]. 2004 Jun; Available from http:// www.apha.org/NR/rdonlyres / (Accessed April 4th, 2017)

Cauldbeck MB, Connor CO, Connor MBO, Saunders JA, Rao B, Mallesh VG et al. Adherence to anti-retroviral thera-py among HIV patients in Bangalore, India. AIDS Research and Therapy [serial online] 2009;6:7. Available from: URL: http://www.aidsrestherapy.com/content/6/1/7 (Accessed April 5th 2017)

Golin CE, Liu H, Hays RD, Miller LG, Beck CK, Ickovics J, et al. A prospective study of predictors of adherence to combination antiretroviral medication. J Gen Intern Med 2002 Oct;17:756 – 765.

Gordillo V, Amo JD, Soriano V, Lohoz JG. Sociodemograph-ic and Psychological variables influencing adherence toan-tiretroviral therapy. AIDS 1999;13:1763-69.

Andrew R. Zolopa,Janet Andersen,Lauren Komarow,Ian Sanne, Alejandro Sanchez, Evelyn Hogg,Carol Suckow, Wil-liam Powderly, Early Antiretroviral Therapy Reduces AIDS Progression/Death in Individuals with Acute Opportunis-tic Infections: A Multi CentreRandomised Strategy Trial, PLoS ONE. 2009; 4(5): e5575.

Surendra K Sharma,Sahajal Dhooria,KT Prasad, Ninoo George,Sanjay Ranjan, Deepak Gupta,Vishnubhatla Sreeni-vas, Tamilarasu Kadhiravan, Sunita Miglani, Sanjeev Sinha, Naveet Wig, Ashutosh Biswas & Madhu Vajpayee, Out-comes of antiretroviral therapy in a northern Indian urban clinic, Bulletin World Health Organ 2010;88:222–226

Sarna A, Pujari S, Sengar AK, Garg R, Gupta I, Vandem J. Adherence to antiretroviral therapy & its determinants amongst HIV patients in India. Indian J Med Res 2008 Jan;127:28-36.

Adane A, Desta K, Bezabih A, Gashaye A, Kassa D, HIV-associated anaemia before and after initiation of antiretrovi-ral therapy at Art Centre of Minilik II Hospital, Addis Aba-ba, Ethiopia, Ethiop Med J. 2012 Jan;50(1):13-21.

N. Kumarasamy, Suniti Solomon,Timothy P. Flanigan, R. Hemalatha, S. P. Thyagarajan, and Kenneth H. Mayer, Natu-ral History of Human ImmunodeficiencyVirus Disease in Southern India, HIV/AIDS • CID 2003:36

Berhane K, Karim R, Cohen MH, Masri-Lavine L, Young M, Anastos K, Augenbraun M, Watts DH, Levine AM. Impact of highly active antiretroviral therapy on anemia and rela-tionship between anemia and survival in a large cohort of HIV-infected women: Women's Interagency HIV Study. J Acquir Immune Defic Syndr. 2004 Oct 1;37(2):1245-52.

Downloads

Published

2017-10-31

How to Cite

1.
Gorantla M, Takalkar A, Kondagunta N. Impact of Anti Retro Viral (ART) Therapy on Clinical and Laboratory Parameters: A Longitudinal Study. Natl J Community Med [Internet]. 2017 Oct. 31 [cited 2024 Mar. 28];8(10):579-82. Available from: https://njcmindia.com/index.php/file/article/view/1365

Issue

Section

Original Research Articles