Authors: Jaya Lalwani, Camilla Rodrigues, Rajeev Soma
Introduction: In resource-limited countries like India, where resistance testing is often not available, an accurate treatment history can guide doctors in quantifying suboptimal drug exposure and thus anticipate drug resistance Materials and Methods: In the present longitudinal study, a total of 75 patients failing antiretroviral therapy; the effective drug exposure was calculated after taking into account the adherence, appropriateness of prescriptions, and pharmacokinetic interactions. Treatment was modified and patients were followed up. Results: Of the total 75 patients included in the study; 69 (92.0%), 63 (84.0%) and 42 (56.0%) patients had virological, immunological and clinical failure respectively. Suspected reasons for antiretroviral drug failure were non-adherence in 48 (64.0%), improper prescriptions in 12(16.0%) and drug interactions in 12 (16.0%). We observed that following treatment change, CD4 count increased by a mean of 127 cells/?l and 33 (44.0%) patients had fully suppressed viral loads. Conclusion: Our results show that empirical treatment changes based on a comprehensive drug history, followed by good adherence lead to good treatment outcomes in patients showing one or other evidence of drug resistance. Keywords: HIV, AIDS, Drug-resistance, Antiretroviral.
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