STUDY OF PATTERN AND SEVERITY OF ADVERSE EFFECT OF SECOND LINE HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN PEOPLE LIVING WITH HIV AND THEIR CORRELARION TO CD4 COUNT

Dr. Anita Basavaraj, Dr. Kruteesh Kumar*, Dr. Ajith Hange, Dr. Chaitanya Patel

ABSTRACT

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, second line ART is being instituted with free of cost under NACO. Aims & Objectives: The aim of this study is to gain knowledge on the severity and pattern of adverse effect of second line HAART drug in patients living with hiv and their correlation with cd4 count in our setup and factors associated with it, with the ultimate goal of improving the tolerability and effectiveness of HIV treatment. Material & Methods:Institution based prospective observational study conducted using review of clinical records and follow up of adult patients started on second line ART from june 2017 to December 2018 at Govt medical college ,miraj . All adult AIDS patients of either sex aged greater than or equal to 20 years who were registered for second line anti-retroviral treatment at Govt medical college ,miraj were included in the study. The clinical records of study subjects were reviewed ADRs. Information on patient’s details, duration of treatment, drug details, nature of the adverse drug reactions, severity, outcome, and results of investigations performed were collected using a data collection format (Annex I). Data were collected from june 2017 to December 2018. Results: 116 cases were included in the study. Among the total 116 patients who were on second line ARV drugs, ADRs were reported in 89 (76.72%) patients. The most frequently observed ADRs were nausea (30.30%), followed by vomiting (27.27%), diarrhea (21.21%) , loss of appetite (18.18%) and vomiting . Out of the 89 patients who developed ADRs, 39 (45.45 %) patients were grade II, whereas grade 3 and 1. ADRs occurred in 29 (25%) and 21(18.10%) of the patients respectively. Grade IV was reported in none of the patients. No ADRs were noted in 27(23.27%) patients. Mean CD4 count for gastro intestinal, CNS, skin hematological , metabolic ,renal , hepatic are 89.91, 98.17, 72.83, 101.8, 80.63 ,90.5 , 153 respectively Conclusion: Second line anti-retroviral drugs are expensive, and the majority of the world's infected individuals do not have access to medications and treatments for HIV and AIDS. Though second line ART regimens are associated with mild to moderate ADRs, these are most effective regimens as they improved CD4 counts and reduced viral load significantly.

Keywords: Pattern, severity, CD4, HAART, HIV, NACO.