India Introduces Second-Line Antiretroviral Treatment

Ruzanna Harutyunyan's picture

India's National AIDS Control Organization is expanding the availability of second-line antiretroviral treatment to HIV-positive people resistant to first-line drugs, the Times of India reports. Now available in eight states, previously, only Mumbai's J. J. Hospital and Chennai's Tambaram ART Center offered second-line treatment.

Under the program, the drugs will be available from the School of Tropical Medicine in Kolkata, B. J. Medical College in Ahmedabad, and additional clinics in Bangalore, Hyderabad, Manipur and Varanasi.

According to Sujatha Rao, NACO director general, the centers in Bangalore and Hyderabad already have introduced second-line therapies and six additional centers have begun recruiting eligible patients for treatment. Rao added that NACO has provided viral load testing kits to the centers and trained physicians to administer the second-line drugs. B. B. Rewari, NACO's national program officer, said the program aims to place 3,000 people living with drug-resistant HIV on second-line antiretroviral treatment by 2009.


He added that patients who already are registered in NACO's antiretroviral treatment centers will be eligible for second-line treatment after approval by a panel of experts. All patients on second-line drugs will receive a treatment course of seven tablets per day and must undergo three rounds of mandatory counseling, Rewari said.

According to Rewari, UNITAID will donate the second-line drugs to India at no cost through the William J. Clinton Foundation for the first two years of the program, after which NACO will negotiate with five Indian pharmaceutical companies to purchase the drugs. About 160 HIV-positive people in eight Indian states are currently receiving second-line treatment, the Times of India reports.

India in January 2008 began introducing second-line treatment, which costs NACO about 100,000 Indian rupees, or about $2,055, per patient annually. According to NACO estimates, of the 195,000 people receiving HIV treatment in India, about 3% likely will become resistant to first-line drugs, primarily because of poor treatment adherence. NACO currently provides antiretroviral treatment through 190 centers and aims to expand access to 250 centers by 2012, according to the Times of India (Sinha, Times of India, 1/5).

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