Prevalence of Failure of First-Line Anti-Retroviral Therapy in HIV Patients : A Retrospective Cross-Sectional Study of Six Districts of Andhra Pradesh Over One Decade

National ART program was launched on 1 April 2004. As the treatment is life long, failure rates need to be assessed periodically, to assess the efficacy of first-line ART (Anti-Retroviral Therapy). This is the largest retrospective, cross-sectional study, from April 2004 to March 2014, conducted at ART–Plus Center, in Government Siddhartha Medical College and Government General Hospital, a tertiary level teaching hospital at Vijayawada, Andhra Pradesh, India. The study population was PLWHA (people living with HIV & AIDS), registered for first-line ART, in 16 nodal ART centers, from 6 districts of Andhra Pradesh (before state bifurcation). We calculated failure of first-line ART and we also analyzed the significance of duration of ART, gender, and base line CD4 count on the prevalence of first-line ART failure. Out of total 57,674 subjects who were on first-line ART, 244 subjects needed second-line ART, with prevalence of first-line ART failure as 0.47%. Mean duration of therapy was 53±23.44 months. There was no significant association between mean duration of ART and first-line ART failure. Males (189) had significantly higher failure rate compared to females (55); (χ 2 =84.03; p = <0.05). There was significant association between low CD4 count and failure of first-line ART (χ 2 =15.48; p = <0.05). Our study has shown that first-line ART in the National ART program is still effective. Second-line ART may be needed only in areas with high prevalence of first-line ART failure.