title: Antiretroviral treatment in Georgia.
abstract: HIV infection is the major public health, social and economic problem in Georgia. The aim of this study is to evaluate effectiveness of ARV treatment system in Georgia. Study included 1052 people living with HIV/AIDS in Georgia registered at Infectious Disease, AIDS and Clinical Immunology Research Center since 2004. To ensure universal access to ARV therapy all HIV/AIDS individuals included in the study were investigated by special algorithm, all identified patients requiring ARV therapy were offered treatment and monitored during therapy on treatment effectiveness and side effects. Detection of HIV antibodies was performed by ELISA with further confirmation by Western Blot Assay. HIV-1 RNA in plasma was measured by quantitative Polymerase Chain Reaction. For determination of percentages and absolute count of T lymphocyte subpopulations single-platform immunophenotyping technique using the Becton-Dickinson FACSCalibur flow cytometer was applied. For resistance testing TRUGENE HIV-1 Genotyping Kit with the OpenGene DNA Sequencing System (Siemens) was used. Treatment was offered to 595 HIV/AIDS patients. 594 patients started treatment, 1 patient refused. Out of treated 594 HIV/AIDS patients 22 patients discontinued, 111 patients died and 461 patients are currently on ARV treatment. Out of treated patients 406 adults and 21 children are receiving first-line treatment, 31 adults and 2 children are on second-line treatment and 1 adult is receiving salvage regimen. Treatment failure was defined in 55 cases. Among them immunological failure was observed in 7 cases, clinical failure in 1 case and virologic failure in 47 cases. Prevalence of drug resistance among virologic failure cases accounted for 72% and inadequate adherence for 28% cases. Majority of death cases among ARV treated patients was due to non-AIDS related or incurable conditions, while deaths due to AIDS related conditions mainly were associated to the delayed referral of patients in already advanced stage of disease. It's worth to mention that highest number of death cases was due to liver failure in HIV/HCV and/or HBV co-infected patients.
authors.affiliation: Iv. Javakhisvhili Tbilisi State University, Faculty of Medicine, Tbilisi, Georgia.
authors.forename: T
authors.initials: T
authors.lastname: Tsertsvadze
authors.forename: N
authors.initials: N
authors.lastname: Bolokadze
authors.forename: L
authors.initials: L
authors.lastname: Sharvadze
authors.forename: P
authors.initials: P
authors.lastname: Gabunia
authors.forename: N
authors.initials: N
authors.lastname: Dvali
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D005846:Georgia (Republic) / Q000453:epidemiology; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D008991:Monitoring, Physiologic; D016896:Treatment Outcome
chemical_list: D000914:Antibodies, Viral