Efficacy of Second Line Anti-retroviral Therapy among HIV/AIDS Patients in South India: A Prospective Observational Study

Background: Acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). Because of treatment failure with first line ART, Roughly 4% of total patients on ART are on second line therapy. Second line ART is being instituted in 10 Centers of excellence in India, Gandhi hospital being one of them in south India. Objective: To detect efficacy of second line Anti-Retroviral therapy in HIV/AIDS patients. Methods: This prospective and observational study of 20 months was done in south Indian tertiary hospital. HIV/AIDS patients receiving second line Anti-Retroviral therapy (ART) due to failure of first line drugs were assessed for viral load and CD4 count before and after therapy and analyzed the same by Repeated Measures ANOVA followed by post hoc analysis by Dunnet’s multiple comparison test, respectively. Results: Total One hundred and sixteen patients received second line ART. Mean viral load was 2, 31280 ± 50913 copies per milliliter and mean CD4 count was 75.03 ± 10.69 cells per cubic millimeter before treatment. After initiation of second line ART, Viral load reduced significantly to 1846 ± 621.4 (p<0.001) and 260.4 ± 183.7 (p<0.001) after six and twelve months of treatment, respectively and CD4 count increased significantly 181.8 ± 14.34 (p<0.001) and 235.7 ± 14.56 (p<0.001) after six and twelve months of treatment, respectively. Conclusion: Second line ART regimens are efficacious regimens as they improved CD4 counts and reduced viral load significantly.