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PLOS ONE  2013 

Scaling Up Antiretroviral Treatment Services in Karnataka, India: Impact on CD4 Counts of HIV-Infected People

DOI: 10.1371/journal.pone.0072188

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Abstract:

Setting Twelve antiretroviral treatment centres under National AIDS Control Programme (NACP), Karnataka State, India. Objective For the period 2004-2011, to describe the trends in the numbers of people living with HIV (PLHIV) registered for care and their median baseline CD4 counts, disaggregated by age and sex. Design Descriptive study involving analysis of routinely captured data (year of registration, age, sex, baseline CD4 count) under NACP. Results 34,882 (97% of total eligible) PLHIV were included in analysis. The number registered for care has increased by over 12 times during 2004-11; with increasing numbers among females. The median baseline CD4 cell count rose from 125 in 2004 to 235 in 2011 – the increase was greater among females as compared to males. However, about two-thirds still presented at CD4 cell counts less than 350. Conclusion We found an increasing trend of median CD4 counts among PLHIV presenting to ART centres in Karnataka, an indicator of enhanced and early access to HIV care. Equal proportion of females and higher baseline CD4 counts among them allays any fear of differential access by gender. Despite this relative success, a substantial proportion still presented at low CD4 cell counts indicating possibly delayed HIV diagnosis and delayed linkage to HIV care. Universal HIV testing at health care facilities and strengthening early access to care are required to bridge the gap.

References

[1]  UNAIDS (2008) Report on the Global AIDS epidemic. Geneva.
[2]  Vittinghoff E, Scheer S, O’Malley P, Colfax G, Holmberg SD et al. (1999) Combination antiretroviral therapy and recent declines in AIDS incidence and mortality. J Infect Dis 179: 717-720. doi:10.1086/314623. PubMed: 9952385.
[3]  Posse M, Meheus F, van Asten H, van der Ven A, Baltussen R (2008) Barriers to access to antiretroviral treatment in developing countries: a review. Trop Med Int Health 13: 904-913. doi:10.1111/j.1365-3156.2008.02091.x. PubMed: 18466183.
[4]  Bachani D, Garg R, Rewari BB, Hegg L, Rajasekaran S et al. (2010) Two-year treatment outcomes of patients enrolled in India’s national first-line antiretroviral therapy programme. Natl Med J India 23: 7-12. PubMed: 20839585.
[5]  Sogarwal R, Bachani D (2009) Are persons living with HIV timely accessing ART services in India? J Indian Med Assoc 107: 288-290.19886383.
[6]  Ferradini L, Jeannin A, Pinoges L, Izopet J, Odhiambo D et al. (2006) Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment. Lancet 367: 1335-1342. doi:10.1016/S0140-6736(06)68580-2. PubMed: 16631912.
[7]  Stringer JS, Zulu I, Levy J, Stringer EM, Mwango A et al. (2006) Rapid scale-up of antiretroviral therapy at primary care sites in Zambia: feasibility and early outcomes. JAMA 296: 782-793. doi:10.1001/jama.296.7.782. PubMed: 16905784.
[8]  World Health Organization (2010)Towards Universal Access. Scaling up priority HIV/AIDS interventions in the health sector. Progress Report 2010 Geneva, Switzerland: World Health Organization.
[9]  Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V et al. (1998) Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study. Group. Lancet 352: 1725-1730.
[10]  Sabin CA, Smith CJ, Gumley H, Murphy G, Lampe FC et al. (2004) Late presenters in the era of highly active antiretroviral therapy: uptake of and responses to antiretroviral therapy. AIDS 18: 2145-2151. doi:10.1097/00002030-200411050-00006. PubMed: 15577647.
[11]  García F, de Lazzari E, Plana M, Castro P, Mestre G et al. (2004) Long-term CD4+ T-cell response to highly active antiretroviral therapy according to baseline CD4+ T-cell count. J Acquir Immune Defic Syndr 36: 702-713. doi:10.1097/00126334-200406010-00007. PubMed: 15167289.
[12]  National AIDS Control Organization (2010) HIV estimates for India 2009 Ministry of Health and Family Welfare, Government of India. Available: . Accessed: 13 June 2011.
[13]  National AIDS Control Organization (2007) Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis. Ministry of Health and Family Welfare, Government of India. Available: . Accessed: 9 May 2011.
[14]  World Health Organization (2010) Antiretroviral therapy for HIV infection in adults and adolescents. Recommendations for a public health approach: 2010 revision World Health Organization. Available: . Accessed: 9 May 2011.
[15]  EpiData Association EpiData Analysis Version 2.2. Available: . Accessed on 9th May 2011.
[16]  National AIDS Control Organization, National Institute of Medical Statistics (2013) Technical Report India HIV Estimates-2012 Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. Available: . Accessed: July 3, 2013.
[17]  Marks G, Crepaz N, Janssen RS (2006) Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS 20: 1447-1450. doi:10.1097/01.aids.0000233579.79714.8d. PubMed: 16791020.
[18]  Fleishman JA, Yehia BR, Moore RD, Gebo KA (2010) The economic burden of late entry into medical care for patients with HIV infection. Med Care 48: 1071-1079. doi:10.1097/MLR.0b013e3181f81c4a. PubMed: 21063228.
[19]  Velasco M, Losa JE, Espinosa A, Sanz J, Gaspar G et al. (2007) Economic evaluation of assistance to HIV patients in a Spanish hospital. Eur J Intern Med 18: 400-404. doi:10.1016/j.ejim.2006.12.013. PubMed: 17693228.
[20]  Krentz HB, Gill J (2010) Despite CD4 cell count rebound the higher initial costs of medical care for HIV-infected patients persist 5 years after presentation with CD4 cell counts less than 350 mμl. AIDS 24: 2750-2753. doi:10.1097/QAD.0b013e32833f9e1d. PubMed: 20852403.
[21]  Mojumdar K, Vajpayee M, Chauhan NK, Mendiratta S (2010) Late presenters to HIV care and treatment, identification of associated risk factors in HIV-1 infected Indian population. BMC Public Health 10: 416. doi:10.1186/1471-2458-10-416. PubMed: 20626905.
[22]  Vives N, Carnicer-Pont D, García de Olalla P, Camps N, Esteve A et al. (2012) Factors associated with late presentation of HIV infection in Catalonia, Spain. Int J STD AIDS 23: 475-480. doi:10.1258/ijsa.2011.011280. PubMed: 22844000.
[23]  Parrott FR, Mwafulirwa C, Ngwira B, Nkhwazi S, Floyd S et al. (2011) Combining qualitative and quantitative evidence to determine factors leading to late presentation for antiretroviral therapy in Malawi. PLOS ONE 6: e27917. doi:10.1371/journal.pone.0027917. PubMed: 22114727.
[24]  Borghi V, Girardi E, Bellelli S, Angeletti C, Mussini C et al. (2008) Late presenters in an HIV surveillance system in Italy during the period 1992-2006. J Acquir Immune Defic Syndr 49: 282-286. doi:10.1097/QAI.0b013e318186eabc. PubMed: 18845959.
[25]  Althoff KN, Gange SJ, Klein MB, Brooks JT, Hogg RS et al. (2010) Late presentation for human immunodeficiency virus care in the United States and Canada. Clin Infect Dis 50: 1512-1520. doi:10.1086/652650. PubMed: 20415573.
[26]  Buchacz K, Armon C, Palella FJ, Baker RK, Tedaldi E et al. (2012) CD4 Cell Counts at HIV Diagnosis among HIV Outpatient Study Participants, 2000-2009. AIDS Res Treat 2012: 869841. PubMed: 21941640.
[27]  (2005) HIV prevalence, unrecognized infection, and HIV testing among men who have sex with men--five U.S. cities, June 2004-April 2005. MMWR Morb Mortal Wkly Rep 54: 597-601.
[28]  Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW et al. 2006) Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep 55: 1-17; quiz CE11-14.
[29]  World Health Organization, UNICEF, UNAIDS (2013) Global update on HIV treatment 2013: results, impact and opportunities World Health Organization. Available: . Accessed: July 3, 2013.
[30]  World Health Organization (2013) Consolidated guidelines for the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. June 2013 World Health Organization. Available: . Accessed: July 3, 2013.

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