New Delhi: Second line treatment – the only hope of life for HIV patients who have become resistant to the standard first line Anti-Retroviral Therapy (ART) – has been rolled out in eight more states.
Till now, only two centres – Mumbai’s J J Hospital and Chennai’s Tambaram ART centre – were treating drug resistant HIV patients. ART is the only known treatment that suppresses the HIV virus. Maulana Azad Medical College in Delhi and PGI in Chandigarh are among the new centres where second line ART is now available. The other places where India’s National AIDS Control Organisation has rolled out the second line therapy are School of Tropical Medicine (Kolkata), B J Medical College (Ahmedabad), Hyderabad, Bangalore, Manipur and Varanasi.
“Bangalore and Hyderabad are rolling out second line therapy from next week. The other six centres have already started recruiting patients who are eligible for the therapy. Doctors have been specially trained to administer second line treatment and viral load testing kits have been put in place,” NACO DG K Sujatha Rao told TOI. India presently has 1.95 lakh HIV infected on treatment. NACO estimates that at least 3% of these patients 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.
India rolled out second line treatment from January 2008. Second line treatment costs NACO Rs 1 lakh per patient per year. Around 160 HIV patients are receiving second line ART in the eight states at present. NACO has in place 190 centres providing ART and plans to increase it to 250 centres by 2012.
Dr B B Rewari, NACO’s national programme officer (ART) told TOI, “We plan to put 3,000 drug resistant HIV patients on second line treatment by the end of 2009.” He added, “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 are on first line drugs. They also experience more side-effects like nausea, vomiting and loss of appetite. Patients who are already registered in NACO’s ART centres will be eligible for the second line treatment after an expert panel gives a go ahead.”
UNITAID, an international drug purchasing facility, has offered to donate the drugs to India for the first two years. From January 2010, NACO will have to tie up with India’s generic drug makers to purchase the highly expensive second line drugs.
“From January next year, buying the drugs will be NACO’s responsibility. At present, UNITAID gives it to us through Clinton Foundation for free. Around five Indian pharma companies manufacture second line therapy drugs,” an official said.