Immunological and virological response in HIV-1 infected patients receiving active antiretroviral therapy at a tertiary care center in Northern India

Arti Agrawal; Anshika Chawla; Astha; Jitendra Kumar Doneria; Nitu Chauhan; Ayushi Gupta; Gargi Tyagi; Parul Garg

doi:10.18502/ijm.v18i1.20936

Arti Agrawal Department of Microbiology, SN Medical College, Agra, India
Anshika Chawla Department of Microbiology, SN Medical College, Agra, India
Astha Department of Microbiology, F.H. Medical College, Agra, India
Jitendra Kumar Doneria Department of Medicine, SN Medical College, Agra, India
Nitu Chauhan Department of Transfusion Medicine, SN Medical College, Agra, India
Ayushi Gupta Department of Liberal Arts and Humanities, Jindal School, Sonipat, Haryana, Agra, India
Gargi Tyagi Department of Administrative, SN Medical College, Agra, India
Parul Garg Department of Microbiology, SN Medical College, Agra, India

DOI: https://doi.org/10.18502/ijm.v18i1.20936

Keywords: HIV 1; CD4; HAART; Immunological response; Polymerase chain reaction; Viral load

Abstract

Background and Objectives: Human Immunodeficiency Virus (HIV) remains a major global health challenge, with limited Indian data on factors influencing treatment outcomes. This study assessed immunological and virological responses and survival determinants among treatment-naïve HIV-1–positive adults.

Materials and Methods: A retrospective observational study was conducted at a tertiary care centre from May 2022 to April 2023. Adults (≥18 years) who initiated first-line ART (TDF + 3TC + DTG) between January 2019 and December 2020 with 24-month follow-up were included. Baseline demographics, CD4 count, viral load, and adherence were analysed using descriptive statistics and logistic regression.

Results: Of 452 screened patients, 355 were eligible. Mortality at 6, 12, and 24 months was 22%, 26.8%, and 29.9%, respec- tively, with overall survival of 70.1%. Baseline CD4 count, viral load, adherence, and ART initiation timing significantly influenced outcomes (p < 0.05). Patients with baseline between 200 to 350 had almost 7 times the odds of survival compared to those with <200 cells/µL. Early ART initiation (≤7 days) improved survival (3-fold) and viral suppression (2.4-fold), while adherence >95% was the strongest predictor of success. Older age and high viral load predicted poorer outcomes.

Conclusion: Early ART initiation, strict adherence, and favourable baseline markers significantly improved survival and suppression, supporting the “test-and-treat” approach and the UNAIDS 95-95-95 targets.