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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/51781
Title: Effect of macrolide prophylactic therapy on AIDS-Defining conditions and HIV-Associated mortality
Authors: Mark Kristoffer U. Pasayan
Mary Lorraine S. Mationg
David Boettiger
Wilson Lam
Fujie Zhang
Stephane Wen Wei Ku
Tuti Parwati Merati
Romanee Chaiwarith
Do Duy Cuong
Evy Yunihastuti
Sasisopin Kiertiburanakul
Nguyen Van Kinh
Anchalee Avihingsanon
Ly Penh Sun
Adeeba Kamarulzaman
Pacharee Kantipong
Nagalingeswaran Kumarasamy
Sanjay Pujari
Benedict Lim Heng Sim
Oon Tek Ng
Jun Yong Choi
Junko Tanuma
Jeremy Ross
Rossana A. Ditangco
Hospital Sungai Buloh
Beijing Ditan Hospital Capital Medical University
VHS Medical Centre India
Gokila
Bach Mai Hospital
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chulalongkorn University
Kirby Institute
National Center for Global Health and Medicine
Yonsei University College of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Queen Elizabeth Hospital Hong Kong
University of Malaya Medical Centre
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
National Hospital for Tropical Diseases
Foundation for AIDS Research
Institute of Infectious Diseases
Chiangrai Prachanukroh Hospital
National Center for HIV/AIDS
Research Institute for Health Sciences
Keywords: Medicine
Issue Date: 1-Apr-2019
Citation: Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.4 (2019), 436-443
Abstract: © 2018 Wolters Kluwer Health, Inc. All rights reserved. Background:Mycobacterium avium complex prophylaxis is recommended for patients with advanced HIV infection. With the decrease in incidence of disseminated Mycobacterium avium complex infection and the availability of antiretroviral therapy (ART), the benefits of macrolide prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART.Methods:Patients from TREAT Asia HIV Observational Database (September 2015 data transfer) aged 18 years and older with a CD4 count <50 cells/mm3 at ART initiation were included. The effect of macrolide prophylaxis on HIV-associated mortality or AIDS-defining conditions (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted in patients with a CD4 <100 cells/mm3 at ART initiation.Results:Of 1345 eligible patients, 10.6% received macrolide prophylaxis. The rate of the combined outcome was 7.35 [95% confidence interval (CI): 6.04 to 8.95] per 100 patient-years, whereas the rate of HIV-associated mortality was 3.14 (95% CI: 2.35 to 4.19) per 100 patient-years. Macrolide use was associated with a significantly decreased risk of HIV-associated mortality (hazard ratio 0.10, 95% CI: 0.01 to 0.80, P = 0.031) but not with the combined outcome (hazard ratio 0.86, 95% CI: 0.32 to 2.229, P = 0.764). Sensitivity analyses showed consistent results among patients with a CD4 <100 cells/mm3 at ART initiation.Conclusions:Macrolide prophylaxis is associated with improved survival among Asian HIV-infected patients with low CD4 cell counts and on ART. This study suggests the increased usage and coverage of macrolide prophylaxis among people living with HIV in Asia.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/51781
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064989723&origin=inward
ISSN: 10779450
15254135
Appears in Collections:Scopus 2019

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