Publication:
Use and Outcomes of Antiretroviral Monotherapy and Treatment Interruption in Adolescents With Perinatal HIV Infection in Asia

Issued Date

2019-11-01

Resource Type

Article

ISSN

18791972
1054139X

DOI

10.1016/j.jadohealth.2019.05.025

Other identifier(s)

2-s2.0-85070102593

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of Adolescent Health. Vol.65, No.5 (2019), 651-659

Suggested Citation

Adam W. Bartlett, Pagakrong Lumbiganon, Nia Kurniati, Tavitiya Sudjaritruk, Thahira J. Mohamed, Rawiwan Hansudewechakul, Penh S. Ly, Khanh H. Truong, Thanyawee Puthanakit, Lam V. Nguyen, Kulkanya Chokephaibulkit, Viet C. Do, Nagalingeswaran Kumarasamy, Nik Khairulddin Nik Yusoff, Moy S. Fong, Dewi K. Watu, Revathy Nallusamy, Annette H. Sohn, Matthew G. Law, V. Khol, J. Tucker, E. Chandrasekaran, D. K. Wati, D. Vedaswari, I. B. Ramajaya, D. Muktiarti, M. Lim, F. Daut, P. Mohamad, M. R. Drawis, K. C. Chan, V. Sirisanthana, L. Aurpibul, P. Ounchanum, S. Denjanta, A. Kongphonoi, P. Kosalaraksa, P. Tharnprisan, T. Udomphanit, G. Jourdain, S. Anugulruengkit, W. Jantarabenjakul, R. Nadsasarn, K. Lapphra, W. Phongsamart, S. Sricharoenchai, Q. T. Du, C. H. Nguyen, T. M. Ha, V. T. An, D. T.K. Khu, A. N. Pham, L. T. Nguyen, O. N. Le, J. L. Ross, C. Sethaputra, A. Kariminia Use and Outcomes of Antiretroviral Monotherapy and Treatment Interruption in Adolescents With Perinatal HIV Infection in Asia. Journal of Adolescent Health. Vol.65, No.5 (2019), 651-659. doi:10.1016/j.jadohealth.2019.05.025 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51353

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Title

Use and Outcomes of Antiretroviral Monotherapy and Treatment Interruption in Adolescents With Perinatal HIV Infection in Asia

Author(s)

Adam W. Bartlett
 Pagakrong Lumbiganon
 Nia Kurniati
 Tavitiya Sudjaritruk
 Thahira J. Mohamed
 Rawiwan Hansudewechakul
 Penh S. Ly
 Khanh H. Truong
 Thanyawee Puthanakit
 Lam V. Nguyen
 Kulkanya Chokephaibulkit
 Viet C. Do
 Nagalingeswaran Kumarasamy
 Nik Khairulddin Nik Yusoff
 Moy S. Fong
 Dewi K. Watu
 Revathy Nallusamy
 Annette H. Sohn
 Matthew G. Law
 V. Khol
 J. Tucker
 E. Chandrasekaran
 D. K. Wati
 D. Vedaswari
 I. B. Ramajaya
 D. Muktiarti
 M. Lim
 F. Daut
 P. Mohamad
 M. R. Drawis
 K. C. Chan
 V. Sirisanthana
 L. Aurpibul
 P. Ounchanum
 S. Denjanta
 A. Kongphonoi
 P. Kosalaraksa
 P. Tharnprisan
 T. Udomphanit
 G. Jourdain
 S. Anugulruengkit
 W. Jantarabenjakul
 R. Nadsasarn
 K. Lapphra
 W. Phongsamart
 S. Sricharoenchai
 Q. T. Du
 C. H. Nguyen
 T. M. Ha
 V. T. An
 D. T.K. Khu
 A. N. Pham
 L. T. Nguyen
 O. N. Le
 J. L. Ross
 C. Sethaputra
 A. Kariminia

Other Contributor(s)

VHS Medical Centre India
 National Hospital of Pediatrics Hanoi
 Universitas Udayana
 Universitas Indonesia
 Chulalongkorn University
 Kirby Institute
 Faculty of Medicine, Khon Kaen University
 Kuala Lumpur Hospital
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Chiang Mai University
 Children's Hospital 2
 National Center for HIV/AIDS
 Children's Hospital 1
 TREAT Asia/amfAR-The Foundation for AIDS Research
 Penang Hospital
 Chiangrai Prachanukroh Hospital
 Hospital Likas
 Hospital Raja Perempuan Zainab II

Abstract

© 2019 Society for Adolescent Health and Medicine Purpose: Antiretroviral monotherapy and treatment interruption are potential strategies for perinatally HIV-infected adolescents (PHIVA) who face challenges maintaining effective combination antiretroviral therapy (ART). We assessed the use and outcomes for adolescents receiving monotherapy or undergoing treatment interruption in a regional Asian cohort. Methods: Regional Asian data (2001–2016) were analyzed to describe PHIVA who experienced ≥2 weeks of lamivudine or emtricitabine monotherapy or treatment interruption and trends in CD4 count and HIV viral load during and after episodes. Survival analyses were used for World Health Organization (WHO) stage III/IV clinical and immunologic event-free survival during monotherapy or treatment interruption, and a Poisson regression to determine factors associated with monotherapy or treatment interruption. Results: Of 3,448 PHIVA, 84 (2.4%) experienced 94 monotherapy episodes, and 147 (4.3%) experienced 174 treatment interruptions. Monotherapy was associated with older age, HIV RNA >400 copies/mL, younger age at ART initiation, and exposure to ≥2 combination ART regimens. Treatment interruption was associated with CD4 count <350 cells/μL, HIV RNA ≥1,000 copies/mL, ART adverse event, and commencing ART age ≥10 years compared with age <3 years. WHO clinical stage III/IV 1-year event-free survival was 96% and 85% for monotherapy and treatment interruption cohorts, respectively. WHO immunologic stage III/IV 1-year event-free survival was 52% for both cohorts. Those who experienced monotherapy or treatment interruption for more than 6 months had worse immunologic and virologic outcomes. Conclusions: Until challenges of treatment adherence, engagement in care, and combination ART durability/tolerability are met, monotherapy and treatment interruption will lead to poor long-term outcomes.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/51353

Collections

Scopus 2019