Second-line drug free to combat AIDS

NEW DELHI: There’s some cheer for HIV patients who have become resistant to the first-line anti-retroviral therapy (ART) – the only known treatment that suppresses the HIV virus.

The National AIDS Control Board (NACB), headed by health secretary Naresh Dayal, in its meeting on June 11, decided to roll out life-saving second-line ART drugs free to HIV patients in Delhi, Kolkata, Ahmedabad and Hyderabad from September.

The hospitals identified to provide the treatment include Maulana Azad Medical College (Delhi), Gandhi Hospital (Hyderabad), School of Tropical Medicine (Kolkata) and B J Medical College (Ahmedabad).

NACB also cleared four states – Manipur, Karnataka, Chandigarh and Uttar Pradesh – where second-line drugs will be rolled out from December. Experts from these eight ART centres are being taken by the WHO to Thailand to study operational issues relating to second-line therapy.

The National AIDS Control Organisation targets to put 3,000 such first-line ART-resistant HIV patients on second-line treatment by the end of 2008. India rolled out second-line therapy for the first time early this year. The announcement was made by health minister A Ramadoss on World AIDS Day on December 1.

As a pilot project, two centres – Mumbai’s J J Hospital and Chennai’s Tambaram ART centre – rolled out the treatment from January. Nearly 200 patients were evaluated by an expert panel and 110 were found to be eligible for second-line treatment with low CD4 count and high viral load.

At present, 79 HIV patients are on second-line treatment in these two centres while the rest are being counselled. Speaking to TOI, Dr B B Rewari, Naco’s national programme officer (ART), said, "Three rounds of counselling are mandatory for all HIV patients being put on second-line therapy under which patients have to consume seven tablets a day instead of two when they were on first-line drugs. They also experience more side-effects like nausea, vomiting and loss of appetite. We want to be sure the patient will adhere to the treatment regimen."

Naco estimates that at least 3% of patients undergoing first-line therapy would have become resistant to first-line drugs, mainly due to poor adherence to the treatment regimen. If not put on second-line immediately, most of these patients would die within a few years.

Kounteya Sinha, for TNN



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