Opportunistic infection at the start of antiretroviral therapy and baseline CD4 + count less than 50 cells/mm 3 are associated with poor immunological recovery

Amod Tilak, Smita Shenoy, Muralidhar Varma, Asha Kamath, Amruta Tripathy, Ravi Sori, Kavitha Saravu

Research output: Contribution to journalArticle

Abstract

There is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital. After approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant. ART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4 + cell count was 65 (39, 98) cells/mm 3 and 160 (95, 245) cells/mm 3 . The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4 + count <50 cells/mm 3 were associated with poor immunological recovery. With long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.

Original languageEnglish
Pages (from-to)163-171
Number of pages9
JournalJournal of Basic and Clinical Physiology and Pharmacology
Volume30
Issue number2
DOIs
Publication statusPublished - 01-01-2019

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Opportunistic Infections
CD4 Lymphocyte Count
Tertiary Healthcare
Therapeutics
Tertiary Care Centers
HIV
Ethics Committees
Intention to Treat Analysis
Lost to Follow-Up
Medical Records
India
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Physiology
  • Pharmacology
  • Drug Discovery

Cite this

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title = "Opportunistic infection at the start of antiretroviral therapy and baseline CD4 + count less than 50 cells/mm 3 are associated with poor immunological recovery",
abstract = "There is a dearth of studies assessing the efficacy and immunological improvement in patients started on antiretroviral therapy (ART) in India. This study was undertaken to assess the 2-year treatment outcomes in HIV-positive patients initiated on ART in a tertiary-care hospital. After approval from the Institutional Ethics Committee, adult HIV-positive patients from a tertiary-care hospital, initiated on ART between January 2013 and February 2015, were included in the study. Data on clinical and immunological parameters were obtained from medical case records over a period of 2 years after initiation of therapy. Intention-to-treat analysis was done using a descriptive approach, using SPSS version 15 (SPSS Inc. Released 2006. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). A logistic regression analysis was done to assess the predictors for poor outcomes. A p-value <0.05 was considered statistically significant. ART was initiated in 299 adult patients. At 1 and 2 years, the median (interquartile range) change in CD4 + cell count was 65 (39, 98) cells/mm 3 and 160 (95, 245) cells/mm 3 . The change observed after 2 years of treatment initiation was statistically significant compared with that after 1 year. Three deaths occurred during the study period and 28 were lost to follow-up. Male sex, presence of at least one opportunistic infection at the start of therapy, and baseline CD4 + count <50 cells/mm 3 were associated with poor immunological recovery. With long-term treatment and regular follow-up, sustained clinical and immunological outcomes can be obtained in resource-limited settings.",
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AU - Varma, Muralidhar

AU - Kamath, Asha

AU - Tripathy, Amruta

AU - Sori, Ravi

AU - Saravu, Kavitha

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