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- Title
Virological failure among people living with HIV receiving second-line antiretroviral therapy in Pune, India.
- Authors
Salvi, Sonali; Raichur, Priyanka; Kadam, Dileep; Sangle, Shashikala; Gupte, Nikhil; Nevrekar, Neetal; Patil, Sandesh; Chavan, Amol; Nimkar, Smita; Marbaniang, Ivan; Mave, Vidya
- Abstract
Background: The number of people receiving second-line antiretroviral therapy (ART) has increased as global access to ART has expanded. Data on the burden and factors associated with second-line ART virologic failure (VF) from India remain limited. Methods: We conducted cross-sectional viral load (VL) testing among adults (≥ 18 years) who were registered at a publicly funded ART center in western India between 2014 and 2015 and had received second-line ART for at least 6 months. Sociodemographic and clinical characteristics were abstracted from routinely collected programmatic data. Logistic regression evaluated factors associated with VF (defined as VL > 1000 copies/mL). Results: Among 400 participants, median age was 40 years (IQR 34–44), 71% (285/400) were male, and 15% (59/400) had VF. Relative to participants without VF, those with VF had lower median CD4 counts (230 vs 406 cells/mm3, p < 0.0001), lower weight at first-line failure (49 vs 52 kg, p = 0.003), were more likely to have an opportunistic infection (17% vs 3%, p < 0.0001) and less likely to have optimal ART adherence (71% vs 87%, p = 0.005). In multivariable analysis, VF was associated with opportunistic infection (aOR, 4.84; 95% CI, 1.77–13.24), lower CD4 count (aOR 4.15; 95% CI, 1.98–8.71) and lower weight at first-line failure (aOR, 2.67; 95% CI, 1.33–5.34). Conclusions: We found second-line VF in about a sixth of participants in our setting, which was associated with nearly fivefold increased odds in the context of opportunistic infection. Weight could be a useful clinical indicator for second-line VF.
- Subjects
PUNE (India); INDIA; HIV-positive persons; ANTIRETROVIRAL agents; OPPORTUNISTIC infections; ART; VIRAL load
- Publication
BMC Infectious Diseases, 2022, Vol 22, Issue 1, p1
- ISSN
1471-2334
- Publication type
Article
- DOI
10.1186/s12879-022-07894-2