(202) Determinants of Treatment Outcomes in HIV Patients with Opportunistic Infections: A Prospective Study in Southern India

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 876

Presenting Author(s)

Balaji Sathyanarayana Gupta, MPharm
– JSS College of Pharmacy, JSS Academy of Higher Education and Research, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India

Co-Author(s)

Vaishnavi Suryadevara
– Deptartment of Pharmacy Practice, JSS College of Pharacy, JSS Academy of Higher Education & Research, Mysuru, India, India
Ramesh Madhan, PhD
– Professor, JSS College of Pharmacy, Mysore, India

Background: The treatment outcomes in co-infected patients with OIs varies from the patients who are solely infected with HIV. In a similar ground there are higher chance of reoccurrence of OIs in these patients because of the weekend immune system and thereby making the treatment more complex and increasing the burden on the patients. It is also clearly indicated that there are several factors that contribute to the poor outcome in co-infected patients.

Objectives: To evaluate the determinants associated with the treatment outcomes in HIV patients with OIs

Methods: A prospective observational study was conducted for a period of 9 months in HIV care centre. All the patients visiting OPD/ getting admitted to the hospital were reviewed and those patients who met the study criteria were enrolled into the study. All the necessary data was collected from various data sources and also by interviewing the patient/ bystanders. The patients were followed-up until the resolution of OIs and the details of treatment outcomes were documented. A multivariable logistic regression analysis was performed to determine the predictors associated with treatment outcomes.

Results: Of the 164 patients enrolled into the study, 230 OIs were detected. Male patients accounted for 71.95%, and most (37.80%) of the patients were in the age group of 40-49 years. The mean age of the study population was 42.37±9.98 years whereas mean body weight and mean height was 51±13 kgs and 162±8 cm respectively. A total of 64.8% (n=133) recovered from the OIs, while defaulted, not recovered, death and transferred out accounted for 5.8% (n=12), 6.3% (n=13), 17.5% (n=36) and 5.4% (n=11) respectively. Overall, the predictors significantly associated with poor treatment outcomes in patients with OIs are low BMI, low grade of education, low CD4 count (baseline and at OI diagnosis), HIV stage 4 (at OI diagnosis), non-adherence to ART. Of the individual OIs, the predictors significantly associated with poor treatment outcomes were low BMI, WHO stage 4 in case of TB, and patients who were not on HAART for TB and candidiasis while favorable treatment outcomes were observed in rural patients presented with PCP.

Conclusions: HIV patients co-infected with TB and candidiasis were at risk for poor treatment outcomes when compared to HIV patients with other OIs. Despite the compliance to treatment guidelines in the study population, there are several factors that led to poor treatment outcomes.