Table 1.
Characteristics of adult PLHIV on second-line ART at BJGMC-SGH ART center, August 2014–September 2015
| Characteristics | Overall (n = 400) | Virological failurea (n = 59) | No virological failure (n = 341) | p |
|---|---|---|---|---|
| Age | ||||
| Median, y (IQR) | 40 (34–44) | 38 (33–42) | 40 (35–45) | 0.10 |
| < 40 | 189 (47.3) | 30 (50.8) | 159 (46.6) | 0.57 |
| ≥ 40 | 211 (52.7) | 29 (49.2) | 182 (53.4) | |
| Sex | ||||
| Male | 285 (71.3) | 42 (71.2) | 243 (71.3) | > 0.95 |
| Female | 115 (28.7) | 17 (27.8) | 98 (28.7) | |
| Time-updated CD4 count, cells/mm3 | ||||
| Median (IQR) | 385 (228–547) | 230 (114–354) | 406 (251–562) | < 0.0001 |
| > 350 | 223 (55.7) | 16 (27.1) | 207 (60.7) | < 0.0001 |
| 200–350 | 95 (23.8) | 21 (35.6) | 74 (21.7) | |
| < 200 | 82 (20.5) | 22 (37.3) | 60 (17.6) | |
| Median time on ART, y (IQR) | ||||
| Overall | 7 (6–9) | 7 (5–9) | 7 (6–9) | 0.30 |
| First-line ART | 4 (3–6) | 4 (3–6) | 4 (3–6) | 0.36 |
| Second line ART | 3 (2–3) | 3 (2–3) | 3 (2–3) | 0.73 |
| < 3 years | 165 (41.2) | 25 (42.4) | 140 (41.1) | 0.89 |
| ≥ 3 years | 235 (58.8) | 34 (57.6) | 201 (58.9) | |
| Marital status | ||||
| Not married | 83 (20.9) | 12 (20.3) | 71 (21.0) | > 0.95 |
| Married | 314 (79.1) | 47 (79.7) | 267 (79) | |
| Education level | ||||
| Illiterate and primary | 105 (26.4) | 18 (31.6) | 87 (25.6) | |
| Secondary | 219 (55.2) | 30 (52.6) | 189 (55.6) | 0.62 |
| College and above | 73 (18.4) | 9 (15.8) | 64 (18.8) | |
| Income category, Indian rupeesb | ||||
| < 5000 | 225 (61.0) | 34 (57.6) | 191 (61.6) | 0.41 |
| 5000–10,000 | 120 (32.5) | 23 (39.0) | 97 (31.) | |
| > 10,000 | 24 (6.5) | 2 (3.4) | 22 (7.1) | |
| Employed | ||||
| No | 88 (22.4) | 14 (23.7) | 74 (22.6) | 0.87 |
| Yes | 305 (77.6) | 45 (76.3) | 260 (77.8) | |
| Smoking | ||||
| No | 323 (83.9) | 53 (89.8) | 270 (82.8) | 0.25 |
| Yes | 62 (16.1) | 6 (10.2) | 56 (17.2) | |
| Alcohol use | ||||
| No | 311 (80.8) | 50 (86.2) | 261 (79.8) | 0.28 |
| Yes | 74 (19.2) | 8 (13.8) | 66 (18.2) | |
| Past opportunistic infectionc | ||||
| No | 170 (43.2) | 26 (44.1) | 144 (43.9) | 0.88 |
| Yes | 224 (56.8) | 33 (55.9) | 191 (56.1) | |
| Present opportunistic infectiond | ||||
| No | 379 (95.0) | 49 (83.1) | 330 (97.1) | < 0.0001 |
| Yes | 20 (5.0) | 10 (16.9) | 10 (2.9) | |
| WHO stage at first-line failure | ||||
| I | 342 (85.5) | 46 (78.0) | 296 (86.8) | 0.24 |
| II | 20 (5.0) | 5 (8.5) | 15 (4.4) | |
| III | 22 (5.5) | 5 (8.5) | 17 (4.9) | |
| IV | 16 (4.0) | 3 (5.1) | 13 (3.8) | |
| Weight at first-line failure, kg | ||||
| Median (IQR) | 51 (45–59) | 49 (42–54) | 52 (45–60) | 0.003 |
| < 51 | 193 (48.3) | 39 (66.1) | 154 (45.2) | 0.003 |
| ≥ 51 | 207 (51.7) | 20 (33.9) | 187 (54.8) | |
| Adherence > 95%e | ||||
| No | 62(15.5) | 17 (28.8) | 45 (13.2) | 0.005 |
| Yes | 338 (84.5) | 42 (71.2) | 296 (86.8) | |
| Protease inhibitor | ||||
| Lopinavir/ritonavir | 15 (3.7) | 1 (2.0) | 14 (4.1) | 0.70 |
| Atazanavir/ritonavir | 385 (96.3) | 58 (98.0) | 327 (95.9) | |
| ART regimen at first-line failure | ||||
| AZT/3TC/NVP | 209 (52.2) | 26 (44.1) | 183 (53.7) | 0.32 |
| d4T/3TC/NVP | 98 (24.5) | 13 (22.03) | 85 (24.9) | |
| AZT/3TC/EFV | 29 (7.3) | 6 (10.1) | 23 (6.7) | |
| d4T /3TC/EFV | 19 (4.7) | 5 (8.5) | 14 (4.1) | |
| TDF/3TC/NVP | 17 (4.2) | 3 (5.1) | 14 (4.1) | |
| TDF/3TC/EFV | 10 (2.5) | 1 (1.7) | 9 (2.6) | |
| Unknown | 18 (4.6) | 5 (8.5) | 13 (3.9) |
Data are presented as n (%), unless otherwise indicated
PLHIV people living with HIV, ART antiretroviral therapy, BJGMC-SGH Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, IQR interquartile range, WHO World Health Organization, AZT Zidovudine, 3TC Lamivudine, NVP Nevirapine, d4T Stavudine, EFV Efavirenz, TDF Tenofovir disoproxil fumarate
aDefined as viral load > 1000 copies/mL after at least 6 months on a second-line regimen
b5000–1000 INR = ~ 64–130 USD (As per May 2022 exchange rate)
cDefined as occurrence of opportunistic infection (including primarily Pulmonary Tuberculosis, Diarrhoea, Herpes Zoster, Candidiasis, Weight loss, Cryptococcal Meningitis, Others) prior to initiation of second line ART
dDefined as occurrence of opportunistic infection after initiation of second line ART
eCalculated as the number of pills consumed divided by the number of pills prescribed multiplied by 100