Presentation is loading. Please wait.

Presentation is loading. Please wait.

High rates of survival, virologic suppression and immune reconstitution among patients receiving second-line ART in the Indian national programme B.B.

Similar presentations


Presentation on theme: "High rates of survival, virologic suppression and immune reconstitution among patients receiving second-line ART in the Indian national programme B.B."— Presentation transcript:

1 High rates of survival, virologic suppression and immune reconstitution among patients receiving second-line ART in the Indian national programme B.B. Rewari 1, M. Shaukat 1, S. Kabra 1, P. Srikantiah 2 1 National AIDS Control Organisation, New Delhi, India 2 University of California, San Francisco, San Francisco, USA XIX International AIDS Conference Washington, D.C. 26 July 2012

2 Background, Objectives, Methods Indian National ART Programme 540,000 persons receive standard first-line ART using public health approach – CD4 cell count every 6 months, no routine VL testing Second-line ART program rolled out across 10 COEs in 2009 – Patients with WHO-defined immunologic and/or clinical failure referred for expert clinical evaluation and viral load testing – Patients with VL >5,000 c/mL started on TDF/3TC/AZT/LPV/rtv* – Standard clinical/CD4 assessment, VL checked after 6 months Objectives: Evaluate 12 and 18 month outcomes of second-line ART patients Examine predictors of virologic suppression, mortality, retention in care Methods: Standardized clinical and laboratory data collected on all adult patients starting second-line ART in India between January 1 and June 30, 2010 * Second-line Regimen changed to TDF/Atazanvir/ritonavir in March 2011

3 Characteristics and Outcomes of Second-line ART Patients (n=411) 73% Immunologic failure, 13% Immunologic and/or Clinical Failure

4 Retention in Care: Factors associated with being Alive and on ART at 12 and 18 months

5 Conclusions and Implications Despite advanced disease at the time of treatment switch, overall patients responded well to standard second-line ART – Good immunologic response and survival – Most surviving patients achieved virologic suppression at 6 months Poor outcomes at 12 and 18 months associated with presence of clinical failure and profound immunosuppression (CD4 <50) at treatment switch – Highlights critical importance of CD4 monitoring in first-line therapy for earlier detection of immunologic failure – Where feasible, routine virologic monitoring in first-line ART can assist earlier identification of failure


Download ppt "High rates of survival, virologic suppression and immune reconstitution among patients receiving second-line ART in the Indian national programme B.B."

Similar presentations


Ads by Google