Although this was a non-comparative study, mortality amongst patients taking NVP-based HAART was found to be lower than in similar stage patients in natural history studies from India [15]. The majority of the clinical events on HAART were defined as IRDs and occurred within 2-12 weeks of initiation of therapy. It is however difficult to separate IRDs from actual occurrence of opportunistic infections since CD4 counts are still low up to 12 weeks after initiation of HAART. In a large, international randomized study with clinical outcomes as primary endpoints, the AZT/3TC/NVP arm was found to have fewer deaths and fewer patients with progression to AIDS compared to the AZT/3TC/placebo [16].

TB was the most common of the clinical events occurring on HAART in this cohort. This is not surprising as TB is the commonest opportunistic infection amongst HIV-infected patients in India. Most TB is either new occurrence or paradoxical worsening of existing infection. It commonly presents at an extra-pulmonary site with lymphadenopathy (external and internal) and tuberculous meningitis. Other common events included herpes zoster, cryptococcal meningitis, Pneumocystis carinii and bacterial pneumonias. However, overall it was found that NVP-based HAART significantly improved clinical outcomes in patients.