The pattern of the initial anti-retroviral drug regimens in HIV patients at a tertiary care hospital

Background and objective: The choice of the anti-retroviral drug therapy has been evolving over the last decade. The objective of this study was to evaluate the current prescribing pattern of the anti-retroviral drugs in treatment-naïve patients before initiating the anti-retroviral therapy. Materials and Methods: A retrospective review of the antiretroviral drugs which had been prescribed to the HIV-infected patients was conducted at a tertiary care hospital in South India. Only adults patients who were of more than 18 years of age, with a positive serology, who had started or had already been receiving the anti-retroviral therapy were included. Their main demographics, the details of the AIDS diagnoses, the laboratory data (CD4 cell counts) and the history of the antiretroviral therapy were collected. Result: The total number of patients was 108. Among them, 76 (70.4%) were males and 32 (29.6%) were females. The mean age of the patients was 38.67 ±10.02years, the mean weight was 52.47± 11.2kg and the mean CD4 count was 256.57 ± 204.6cells/cumm. Among these patients, 34(31.5%) were on the lamivudine+ zidovudine+ nevirapine regimen, 70(64.8%) were on the lamnivudine + nevirapine+ stavudine regimen (3TC + NVP+ d4T) and 4(3.7%) were on the tenofovir+ emtricitabine +efavirenz regimen. In the first regimen, the mean age of the patients was 39.09 ±9.1years, the mean weight was 51.87±10.7kg and the mean CD4 count was 253.21±177.8cells/cumm. In the second regimen, the mean age of the patients was 38.73 ±10.59 years, the mean weight was 52.37±12.24kg and the mean CD4 count was 262.02± 221.4 cells /cumm. The comparison of the mean age and the mean CD4 count among the patients in the different regimens did not show any statistical significance. Conclusion: The most frequently used antiretroviral drug regimen was the 3TC + NVP+ d4T combination. The prescription pattern was quite in contrast to that which was followed in the developed countries. Newer NRTIs were less frequently used.