What influences adherence among HIV patients presenting with first-line antiretroviral therapy failure (ART failure)? A retrospective, cross-sectional study from a private clinic in Nagpur, India

Shanmukhappa, Sanjana Chetana; Abraham, Rahul R; Huilgol, Poorva; Godbole, Rekha; Anand, Ashoojit Kaur; Prasad, Ramakrishna; Shridhar, Varsha; Bhrushundi, Milind

doi:10.4103/jfmpc.jfmpc_1155_20

Cited by 3 publications

(3 citation statements)

References 31 publications

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“…In the published literature, a good professional support in the form of counselling is reported to be an important predictor for treatment seeking and adherence. 31 A total of 92% admitted to taking treatment regularly. This adherence rate is high compared to studies in the literature, 32 it could be attributed to the small sample size of the study as well as self-report data involving recall bias.…”

Section: Discussionmentioning

confidence: 99%

Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India

Kaur,

Sharma

et al. 2024

Nursing & Midwifery Research Journal

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HIV is a major health issue globally. Though highly effective antiretroviral therapy has improved the life expectancy, people living with HIV (PLHIV) suffer from many physical and psychological issues. The present study assessed perceived health status, quality of life (QOL) and treatment-seeking behaviour among PLHIV. The study was carried out among 75 PLHIV attending ART clinic of a tertiary care centre of North India. Convenience sampling technique was used. Ethical approval for the study was obtained from the Institute Ethics Committee. Participants were asked to rate their current state of health as perceived by them on a five-point scale ranging from poor to excellent. QOL was assessed by using WHOQOL-BREF (Hindi version). Treatment-seeking behaviour was assessed by a structured questionnaire developed by researchers. A total of 45.3% ( n = 34) rated it as fair, 22.7% ( n = 17) rated it as good 13.3% ( n = 10) rated it as poor, 10.7% ( n = 8) rated it as excellent and 8% ( n = 6) rated it as very good. QOL score was highest in physical health domain with a mean ± S.D. of 12.3 ± 4.1 (median 13) and lowest in the social relationships domain with a mean of 8.6 ± 2.9 (median = 8) ( p = .001). Most common reason of going for HIV testing was being symptomatic ( n = 21) followed by spouse testing positive for HIV ( n = 19). HIV impacts QOL of the PLHIV and treatment-seeking behaviour varies among the patients. There is a need to develop a multilevel approach involving all the stakeholders including patient, family and society.

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Section: Discussionmentioning

confidence: 99%

Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India

Kaur,

Sharma

et al. 2024

Nursing & Midwifery Research Journal

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“…A recent study from India stated that high costs, alcoholism, choosing non-allopathic drugs, and depression were the most frequent causes of inadequate adherence and treatment termination. Missed doses were attributed to various factors, including feeling well, depression, forgetfulness, and a busy schedule [ 27 ]. The remarkable improvements in HIV-related health indices could eventually be negated by nonadherence.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Immunological Profiles of HIV/AIDS Patients With First-Line Antiretroviral Treatment Failure Attending a Tertiary Care Hospital

Phukan,

Baruah

et al. 2023

Cureus

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Objectives Highly active antiretroviral therapy (HAART) has decreased morbidity and mortality among HIV/AIDS-infected patients; however, many patients experience treatment failure. The present study aims to evaluate HIV-infected patients' clinical and immunological profiles with first-line antiretroviral treatment (ART) failure (immunological and clinical) at tertiary care hospitals in Northeast India and explore related treatment failure factors. Methods The hospital-based observational study was conducted among HIV-infected patients with first-line ART failure attending a tertiary care hospital from July 1, 2019, to June 30, 2020. The type of first-line ART failure was defined as a clinical, immunological, or virological failure as decided by the State AIDS Clinical Expert Panel (SACEP) meeting. Data were analyzed with Windows MS Excel (Microsoft Corporation, Redmond, Washington) and Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY). Results Among the 90 HIV-infected patients experiencing first-line ART treatment failure, the majority, 38 (42.2%), were in the age group of 30-40 years, 64 (71.1%) were males, and 70 (77.8%) were of average weight. Tuberculosis was the most typical opportunistic infection, affecting 11 (12.2%) patients. Most patients (38.9%) were initially presented at clinical stage 3. Maximum failures were experienced by patients with baseline CD4 ranging from 100-200 cells/mm 3 , with 38 (42.2%) patients, and by patients on efavirenz (64.5%) and tenofovir-based regimens (56.6%). Failures occurred more for 24-30 months and were common among patients with adherence below 90%. Conclusion Treatment failure was more common among young male patients and those with normal body mass index (BMI). Low baseline CD4 count and poor adherence were influential in the occurrence of treatment failure. First-line ART failure was higher in tenofovir- and efavirenz-based regimens.

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“…In order to achieve complete viral suppression, there is need to maintain consistently elevated drug levels within an individual. However, in most individuals, this is not possible for a number of reasons: poor adherence, incorrect drug dose, drug interactions, and poor absorption among others [29][30][31][32][33][34][35]. This results in insu cient drug levels within an individual which then enable the virus to replicate under these suboptimal drug conditions.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of minority Human Immunodeficiency virus multi-drug resistant mutations among patients failing a Nucleoside Reverse Transcriptase Inhibitor based regimen in Uganda

Nankya¹,

Nabulime²,

Kyeyune³

et al. 2021

Preprint

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Objective To determine the prevalence of multi-drug resistant variants among patients failing on a nucleoside reverse transcriptase inhibitor (NRTI) based regimen with a detectable viral load ≥ 1000 copies/ml among patients harboring HIV subtype A, C and D. Methods Samples were obtained from patients who were failing on an NRTI based regimen. Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was further analyzed using the Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cut off Results Analysis of the Non-nucleoside reverse transcriptase inhibitor (NNRTI) coding region revealed that the K101 and the Y181 mutations were more predominant among subtype C than subtype A and D. Although Thymidine analog mutations (TAMs) were prevalent in all subtypes, our analyses showed that these mutations occurred in significantly less proportions among subtype C infections when compared with the subtype A and D counterparts. Furthermore, the Q151M mutation complex which involves mutations in multiple domains was significantly more prominent among patients harboring subtype C variants. Analysis using NGS revealed that minority drug resistant mutations that confer multi-drug resistance (MDR) were present even in patients who exhibited a susceptible genotype based on the Sanger sequencing technique. Conclusion Although HIV-1 MDR variants occur in all subtypes, their predominance is subtype specific with TAMs being significantly more predominant among subtype A and D while the Q151M complex being significantly more predominant among patients harboring subtype C viruses. Even in patients with a susceptible genotype based on Sanger technology, minority variants are present and their evolution to full blown MDR occurs over time such that by the time they are detectable, cross resistance to other drugs has occurred in some cases.

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What influences adherence among HIV patients presenting with first-line antiretroviral therapy failure (ART failure)? A retrospective, cross-sectional study from a private clinic in Nagpur, India

Cited by 3 publications

References 31 publications

Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India

Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India

Clinical and Immunological Profiles of HIV/AIDS Patients With First-Line Antiretroviral Treatment Failure Attending a Tertiary Care Hospital

Prevalence of minority Human Immunodeficiency virus multi-drug resistant mutations among patients failing a Nucleoside Reverse Transcriptase Inhibitor based regimen in Uganda

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