A PROSPECTIVE STUDY TO COMPARE THE EFFECT OF DIFFERENT HAART REGIMENS ON CD4 COUNTS OF HIV PATIENTS WITH TUBERCULOSIS

Introduction: AIDS is one the most dreaded diseases of human race in the present times. More than two- third of HIV infected individuals have an associated infectious pulmonary disease. Mycobacterium tuberculosis is considered as more virulent compared to other opportunistic pathogen causing latent infection. Cure of AIDS is still an unsolved mystery but some of the drugs have been developed to decrease the mortality and morbidity of the disease. These are called as Highly Active Anti-Retroviral Therapy (HAART). This work has been conducted in order to know the role of various anti-retroviral regimens in the treatment of patients of Acquired Immuno Deficiency Syndrome (AIDS) in terms of changes in CD4 count as well as in CD4/CD8 ratio. Material and Methods: A total of 3078 patients screened for the study. Those who were diagnosed with HIV were enrolled. Pretreatment parameters like Haemogram, CD4, CD8 + lymphocyte count and their ratio etc. were recorded. Patients were divided into four groups and were started with different HAART regimens. Their CD4 count and CD4/CD8 ratio were monitored regularly. Results: The prevalence of HIV sero-positivity in our study was 3.60%. Tuberculosis was the most common diagnosis among the seropositive cases. Baseline CD4 count was <50 cells/ µl in 31.67% of the patients. The mean CD4 count was 134.25 ± 99.44 cells/µl. Out of them 50% were having CD4/CD8 count <0.20. Out of 60 patients who were monitored for CD4 count, only 42 revisited for follow up. They were divided into 4 groups and started with HAART regimens. The mean CD4 count and CD4/CD8 ratio were observed to be increase after 3, 6, & 9 months of HAART in all the groups. But when this increase was compared between different groups, it was not significant (ANOVA test; p value >0.05). Conclusion: After starting on HAART regimens, 74.4% showed significant improvement in symptoms. The mean CD4 count and CD4/CD8 ratio observed to be increased after 3, 6, & 9 months of HAART in all the groups. When compared between different groups, the difference was not significant (ANOVA test; p value >0.05).