Newsline had first reported about the revised national guidelines of NACO to incorporate the alternative treatment regime in the free first line drugs already provided at ART centres in the country.

“NACO has finished the tendering process and soon all the 10 centres, including JJ Hospital in Maharashtra, will be able to give alternative treatment,” said Dr Rekha Jain of Maharashtra State Aids Control Society (MSACS).

The news comes as a relief to about 150 HIV patients across Maharashtra who are resistant to first line treatment and are taking second line treatment at private hospitals.

The news about the alternative treatment was announced at a first of its kind public hearing on the ‘importance of second line ART drugs’ where People Living with HIV (PLHIV) from across the state gathered to sensitise policymakers and civil society organisations about the importance of second line ART drugs. “Most of the patients on first line treatment are developing resistance to anti-HIV drugs. Second line treatment is available only at JJ Hospital. Not all patients can travel as they are weak and resort to private practitioners,” said Pravin from Network of Maharashtra by People Living with HIV (NMP+).

“Most of these patients need alternate drug therapy rather than second line drugs,” said Dr Ramesh Devkar, project director MSACS.

“Increasingly, toxicity of ART is becoming an important issue in the management of patients with HIV. The first line ART treatment has improved the CD4 count (used to assess a person’s immune system) and has decreased the incidence of opportunistic infection. But with continued use, the complications of treatment are being seen,” said Dr Alaka Deshpande, in-charge of the ART centre at the J J Hospital, the largest in the country. “Despite toxicity, permanent and proper adherence to the therapy is needed to maximise its long-term benefits,” Dr Deshpande added.

According to doctors, approximately 10 per cent of patients on the first line of ART treatment are developing toxicity to drugs. Although adverse reactions to the therapy are common and profoundly affect its clinical efficacy, many such reactions are poorly studied, analysed and under-reported, say doctors.