OUTCOME OF EMPIRICAL TREATMENT CHANGE IN PATIENTS FAILING ANTIRETROVIRAL TREATMENT

Jaya Lalwani; Rajeev Soman; Camilla Rodrigues; Tanu Singhal; FD Dastur

Volume : VI, Issue : IV, April - 2016

OUTCOME OF EMPIRICAL TREATMENT CHANGE IN PATIENTS FAILING ANTIRETROVIRAL TREATMENT

Jaya Lalwani, Rajeev Soman, Camilla Rodrigues, Tanu Singhal, Fd Dastur

Abstract :

Background: In resource limited settings when resistance testing is often not available a good treatment history can help in quantifying suboptimal drug exposure and anticipating nature of resistance. Material & Methods: In this observational study of 25 patients failing antiretroviral therapy the effective drug exposure was calculated after taking into consideration adherence, appropriateness of prescriptions and kinetic interactions. Treatment was modified and patients were followed up. Results: Of the 25 patients, 23 had virological failure, 21 immunological failure and 14 clinical failure. Possible reasons for failure were non adherence in 16, improper prescriptions in 4 and drug interactions in 4. Following treatment change CD4 count increased by a mean of 127 cells/µl and 11 out of 25 patients had fully suppressed viral loads. Discussion: Despite certain limitations, our results show that, empiric treatment changes based on a comprehensive drug history followed by good adherence leads to a good treatment outcomes.