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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/40852
Title: Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD
Authors: Awachana Jiamsakul
Stephen J. Kerr
Oon Tek Ng
Man Po Lee
Romanee Chaiwarith
Evy Yunihastuti
Kinh Van Nguyen
T. T. Pham
Sasisopin Kiertiburanakul
Rossana Ditangco
Vonthanak Saphonn
Benedict L.H. Sim
Tuti Parwati Merati
Wingwai Wong
Pacharee Kantipong
Fujie Zhang
Jun Yong Choi
Sanjay Pujari
Adeeba Kamarulzaman
Shinichi Oka
Mahiran Mustafa
Winai Ratanasuwan
Boondarika Petersen
Matthew Law
Nagalingeswaran Kumarasamy
C. V. Mean
V. Khol
H. X. Zhao
N. Han
P. C.K. Li
W. Lam
Y. T. Chan
S. Saghayam
C. Ezhilarasi
K. Joshi
S. Gaikwad
A. Chitalikar
D. N. Wirawan
F. Yuliana
D. Imran
A. Widhani
J. Tanuma
T. Nishijima
S. Na
J. M. Kim
Y. M. Gani
R. David
S. F. Syed Omar
S. Ponnampalavanar
I. Azwa
N. Nordin
E. Uy
R. Bantique
W. W. Ku
P. C. Wu
P. L. Lim
L. S. Lee
P. S. Ohnmar
P. Phanuphak
K. Ruxrungtham
A. Avihingsanon
P. Chusut
S. Sungkanuparph
L. Chumla
N. Sanmeema
T. Sirisanthana
W. Kotarathititum
J. Praparattanapan
P. Kambua
R. Sriondee
V. H. Bui
K. V. Nguyen
T. H.D. Nguyen
T. D. Nguyen
D. D. Cuong
H. L. Ha
A. H. Sohn
N. Durier
D. A. Cooper
D. C. Boettiger
University of New South Wales (UNSW) Australia
The HIV Netherlands Australia Thailand Research Collaboration
Academic Medical Centre, University of Amsterdam
Tan Tock Seng Hospital
Queen Elizabeth Hospital Hong Kong
Chiang Mai University
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
National Hospital for Tropical Diseases
Bach Mai Hospital
Mahidol University
Gokila
Dermatology and STDs and University of Health Sciences
Hospital Sungai Buloh
Universitas Udayana
Veterans General Hospital-Taipei
Chiangrai Prachanukroh Hospital
Beijing Ditan Hospital
Yonsei University College of Medicine
Institute of Infectious Diseases
University of Malaya Medical Centre
National Center for Global Health and Medicine
Hospital Raja Perempuan Zainab II
amfAR - The Foundation for AIDS Research
VHS Medical Centre India
Research Institute for Health Sciences
Keywords: Immunology and Microbiology
Issue Date: 1-May-2016
Citation: Tropical Medicine and International Health. Vol.21, No.5 (2016), 662-674
Abstract: © 2016 John Wiley & Sons Ltd. Objectives: Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Methods: Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P < 0.10 in univariable analyses were included in multivariable analyses, where P < 0.05 was considered statistically significant. Results: Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). Conclusions: Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84963722410&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/40852
ISSN: 13653156
13602276
Appears in Collections:Scopus 2016-2017

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