Immunological and virological response in HIV-1 infected patients receiving active antiretroviral therapy at a tertiary care center in Northern India

Background and Objectives: Human Immunodeficiency Virus (HIV) remains a major global health challenge, with limited Indian data on factors influencing treatment outcomes. This study assessed immunological and virological responses and survival determinants among treatment-naïve HIV-1-positive adults. Materials and Methods: A retrospective observational study was conducted at a tertiary care centre from May 2022 to April 2023. Adults (≥18 years) who initiated first-line ART (TDF + 3TC + DTG) between January 2019 and December 2020 with 24-month follow-up were included. Baseline demographics, CD4 count, viral load, and adherence were analysed using descriptive statistics and logistic regression. Results: Of 452 screened patients, 355 were eligible. Mortality at 6, 12, and 24 months was 22%, 26.8%, and 29.9%, respectively, with overall survival of 70.1%. Baseline CD4 count, viral load, adherence, and ART initiation timing significantly influenced outcomes (p < 0.05). Patients with baseline between 200 to 350 had almost 7 times the odds of survival compared to those with 95% was the strongest predictor of success. Older age and high viral load predicted poorer outcomes. Conclusion: Early ART initiation, strict adherence, and favourable baseline markers significantly improved survival and suppression, supporting the "test-and-treat" approach and the UNAIDS 95-95-95 targets.