title: Initial virologic response and HIV drug resistance among HIV-infected individuals initiating first-line antiretroviral therapy at 2 clinics in Chennai and Mumbai, India.
abstract: Human immunodeficiency virus drug resistance (HIVDR) in cohorts of patients initiating antiretroviral therapy (ART) at clinics in Chennai and Mumbai, India, was assessed following World Health Organization (WHO) guidelines. Twelve months after ART initiation, 75% and 64.6% of participants at the Chennai and Mumbai clinics, respectively, achieved viral load suppression of <1000 copies/mL (HIVDR prevention). HIVDR at initiation of ART (P <.05) and 12-month CD4 cell counts <200 cells/μL (P <.05) were associated with HIVDR at 12 months. HIVDR prevention exceeded WHO guidelines (≥ 70%) at the Chennai clinic but was below the target in Mumbai due to high rates of loss to follow-up. Findings highlight the need for defaulter tracing and scale-up of routine viral load testing to identify patients failing first-line ART.
authors.affiliation: National AIDS Research Institute, Pune, India.
authors.forename: Nitin K
authors.initials: NK
authors.lastname: Hingankar
authors.forename: Smita R
authors.initials: SR
authors.lastname: Thorat
authors.forename: Alaka
authors.initials: A
authors.lastname: Deshpande
authors.forename: S
authors.initials: S
authors.lastname: Rajasekaran
authors.forename: C
authors.initials: C
authors.lastname: Chandrasekar
authors.forename: Suria
authors.initials: S
authors.lastname: Kumar
authors.forename: Padmini
authors.initials: P
authors.lastname: Srikantiah
authors.forename: Devidas N
authors.initials: DN
authors.lastname: Chaturbhuj
authors.forename: Sharda R
authors.initials: SR
authors.lastname: Datkar
authors.forename: Pravin S
authors.initials: PS
authors.lastname: Deshmukh
authors.forename: Smita S
authors.initials: SS
authors.lastname: Kulkarni
authors.forename: Suvarna
authors.initials: S
authors.lastname: Sane
authors.forename: D C S
authors.initials: DC
authors.lastname: Reddy
authors.forename: Renu
authors.initials: R
authors.lastname: Garg
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jordan
authors.forename: Sandhya
authors.initials: S
authors.lastname: Kabra
authors.forename: Srikanth P
authors.initials: SP
authors.lastname: Tripathy
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D044966:Anti-Retroviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D024882:Drug Resistance, Viral; D005260:Female; D006678:HIV / Q000187:drug effects* / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D059012:Lost to Follow-Up; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D016896:Treatment Outcome; D019562:Viral Load / Q000706:statistics & numerical data; D014944:World Health Organization
chemical_list: D044966:Anti-Retroviral Agents