Follow-up of patients with First line antiretroviral therapy, Cluster Differentiation (CD4) counts are done every 6 months. Viral load is not possible in resource poor settings like India. Non-Governmental Organisation (NGO's), Human Immunodeficiency Virus (HIV) treating physicians and international guidelines recommend viral load as the follow-up method for first line failure, so to study the impact of national program with immunological criteria and its sensitivity to identify virological failure is needed at this juncture.