HIVIND

The antiretroviral roll out for HIV in India - strengthening capacity to promote adherence and patient follow-up in the context

Coordinatore	KAROLINSKA INSTITUTET    more  Organization address address: Nobels Vag 5 city: STOCKHOLM postcode: 17177 contact info Titolo: Ms. Nome: Anna-Britta Cognome: Karlsson Email: send email Telefono: +46 8 524 833 90
Nazionalità Coordinatore	Sweden [SE]
Sito del progetto	http://hivind.eu/
Totale costo	3˙881˙494 €
EC contributo	2˙946˙420 €
Programma	FP7-HEALTH Specific Programme "Cooperation": Health
Code Call	FP7-HEALTH-2007-B
Funding Scheme	CP-SICA
Anno di inizio	2008
Periodo (anno-mese-giorno)	2008-11-01   -   2014-04-30

 Partecipanti

#	participant	country	role	EC contrib. [€]
1	KAROLINSKA INSTITUTET  Organization address address: Nobels Vag 5 city: STOCKHOLM postcode: 17177 contact info Titolo: Ms. Nome: Anna-Britta Cognome: Karlsson Email: send email Telefono: +46 8 524 833 90	SE (STOCKHOLM)	coordinator	880˙333.00
2	CBCI Society for Medical Education  Organization address address: St. John's National Academy of Health Sciences city: Bangalore postcode: 560034 contact info Titolo: Prof. Nome: Anura Cognome: Kurpad Email: send email Telefono: 918026000000 Fax: 918026000000	IN (Bangalore)	participant	889˙915.00
3	Y.R. GAITONDE MEDICAL EDUCATION & RESEARCH FOUNDATION  Organization address address: "Rajiv Gandhi Salai, Taramani" city: Chennai postcode: 600113 contact info Titolo: Mr. Nome: Ak Cognome: Ganesh Email: send email Telefono: 914423000000 Fax: 914423000000	IN (Chennai)	participant	710˙073.00
4	TAMPEREEN YLIOPISTO  Organization address address: Kalevantie 4 city: TAMPERE postcode: 33014 contact info Titolo: Prof. Nome: Per Cognome: Ashorn Email: send email Telefono: +358 3 3551 8410 Fax: 358336000000	FI (TAMPERE)	participant	189˙688.00
5	CAVIDI AB  Organization address city: Uppsala postcode: 75183 contact info Titolo: Dr. Nome: Clas Cognome: Kallander Email: send email Telefono: 4618552043 Fax: 4618552041	SE (Uppsala)	participant	146˙408.00
6	Hanoi Medical University  Organization address address: Ton That Tung- Dong Da 1 city: HANOI postcode: 10000 contact info Titolo: Prof. Nome: Nguyen Duc Cognome: Hinh Email: send email Telefono: 8448523798 Fax: 8448525115	VN (HANOI)	participant	130˙003.00

Mappa

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 Obiettivo del progetto (Objective)

'India is a nation of contrasts. The economy is modernizing, but the culture is traditional. Different provinces experience the HIV epidemic differently; even in high-prevalence areas, the epidemic reflects diverse social, cultural, religious, & sexual practices. This proposal focuses on 2 high prevalence provinces. As the antiretroviral (ART) program is scaled up, adherence is a key issue that needs to be addressed (as it is a key determinant of resistance, which has public health consequences). With limited affordable second-line regimens & restricted laboratory monitoring in low-income settings, optimal adherence to first-line regimens is essential. The study is a randomized controlled trial of an approach using a contextually relevant intervention (mobile telephones) to influence ART adherence in 600 ART naïve, HIV Indian patients eligible for ART, in Karnataka and Tamil Nadu. The conventional existing approach (as in the national guidelines) will be compared with an intervention in which the patient is provided adherence support using a mobile telephone interface. The study besides assessing the effect of intervention on adherence, will also provide data on the proportion of Indian patients failing first line ART. A study of factors associated with adherence, hitherto unstudied in India will be done. In addition the incidence and manifestations of opportunistic infections, immune reconstitution syndrome & adverse drug events will be described. The use of validated low-cost tests that optimize monitoring, are necessary here. Viral load is rarely used to monitor treatment because it is expensive. Instead falling CD4 counts are used. This usually occurs months/years after virological failure (increasing load); patients could have accumulated enough resistant mutations in this time to render other drugs useless. Using an affordable load test (evaluated in this study) will allow earlier detection of failure in this setting, thus having public health implications. Cost effectiveness will be studied. The project has policy implications for India and other low income settings.'

Introduzione (Teaser)

Better adherence of HIV-infected patients to antiretroviral therapy (ART) can improve outcomes and lower the risks of drug-resistant HIV strains emerging. Techniques to improve ART adherence and patient follow-up were investigated in south India.