The immunological response after the initiation of the second line anti-retroviral therapy (ART) in HIV patients

Introduction: The treatment with the second line ART is initiated when the first line therapy fails. There is less experience with the immunologic response for the second-line ART for adults. Hence, this study was done to find out the immunological response after the initiation of the second line ART by doing an analysis of the CD4 counts. Methods: This retrospective study is conducted in a tertiary level hospital which was attached to a medical college that caters to a large number of HIV positive patients. The study population for this analysis included all the HIV positive individuals who were undergoing the second line ART treatment. The data was collected by using a semi-structured, pre-tested proforma which was obtained from the hospital records of the HIV positive individuals. The immunological response after the initiation of the second line ART was analyzed by using the CD4 cell counts which were taken at intervals of 3 months and 6 months after the initiation of the treatment. Results: Of the 32 patients who were studied, 27(84.4%) were males and only 5(15.6%) were females. The mean age of the patients was 40.56±6.78 years. The mean CD4 value at the initiation of the treatment was 152.35±142.89 cells/μL, which significantly increased to 324.43 ±163.65cells /μL within 3 months after the initiation (p value=.000) and to 348.21±253.57cells /μL by 6 months after the initiation. Around 91.3% of the patients had a baseline CD4 T cell count of <350 cells L-6. After 3 months of therapy, 65.2% of the patients and after 6 months, 46.2% of the patients had a baseline CD4 T cell count of <350 cells /μL. The mean weight at the initiation of the treatment was 50.548±11.37 kg, which very significantly increased to 53.30±11.1 kg within 3 months of therapy (p=.001, table 1) and to 54.63±10.29kg at the end of 6 months. Conclusion: The CD4 counts increased very significantly within the first 3 months of the initiation of the second line therapy. The rise in the CD4 count between 3 months and 6 months is not as statistically significant as the earlier one. Also, there is significant gain in weight within 6 months of the initiation of the second line therapy.