A study on clinico-immunologic response and virologic suppression rates of antiretroviral therapy in the treatment of naïve HIV-positive patients at a tertiary care hospital in Eastern India

ABSTRACT Background: The tenofovir–lamivudine–efavirenz regimen was introduced in 2018, and there was a lack of data on the treatment trends in human immunodeficiency virus (HIV) patients in India. Therefore, we initiated this study. Objectives: Our objective was to evaluate the clinical and immunological response to antiretroviral therapy (ART), as well as the virological suppression rate in antiretroviral-naïve HIV-positive patients attending the School of Tropical Medicine in Kolkata, West Bengal, India. Settings and Design: This longitudinal prospective study was conducted at the School of Tropical Medicine in Kolkata from July 2019 to May 2020. Materials and Methods: A total of 106 treatment-naïve HIV-infected patients were recruited and evaluated for clinical, immunological, and virological responses over 6 months following the initiation of ART. Statistical analysis: All statistical calculations were performed using R software version 4.0.2. Comparisons between observations were made using the t test, and statistical associations were assessed with Fisher’s exact test. Results: All patients were diagnosed with HIV-1 infection, and the mean time to ART initiation was 12.9 days, with a standard deviation of 8.6 days. Among the participants, 75 patients (70.8%) had at least one opportunistic infection (OI), the most common being oral candidiasis, followed by extrapulmonary tuberculosis. Additionally, 59 patients (55.7%) had multiple OIs. The majority of the study population (77.4%) presented with advanced HIV disease. Six patients (5.7%) developed immune reconstitution inflammatory syndrome during the 6-month follow-up period. At baseline, most patients had a CD4 count between 150 and 200 cells/μL, and after 6 months of follow-up, most had a CD4 count above 300 cells/μL. Viral suppression was achieved in 97.1% of patients. Excluding those with poor adherence, the efficacy of the tenofovir–lamivudine–efavirenz regimen in suppressing HIV viral load was 99%. Conclusion: This study concludes that there was a significant improvement in clinical and immunological responses, as well as virological suppression, following the initiation of ART in ART-naïve HIV-positive patients at 6 months follow-up.