Publication: Early and Late Virologic Failure after Virologic Suppression in HIV-Infected Asian Children and Adolescents
Issued Date
2019-03-01
Resource Type
ISSN
10779450
15254135
15254135
Other identifier(s)
2-s2.0-85061499788
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.3 (2019), 308-315
Suggested Citation
Weiwei Mu, Adam W. Bartlett, Torsak Bunupuradah, Kulkanya Chokephaibulkit, Nagalingeswaran Kumarasamy, Penh Sun Ly, Rawiwan Hansudewechakul, Lam Van Nguyen, Pagakrong Lumbiganon, Tavitiya Sudjaritruk, Thahira A.Jamal Mohamed, Nik Khairulddin Nik Yusoff, Khanh Huu Truong, Viet Chau Do, Moy Siew Fong, Revathy Nallusamy, Nia Kurniati, Dewi Kumara Wati, Annette H. Sohn, Azar Kariminia, Fujie Zhang Early and Late Virologic Failure after Virologic Suppression in HIV-Infected Asian Children and Adolescents. Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.3 (2019), 308-315. doi:10.1097/QAI.0000000000001921 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51846
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Title
Early and Late Virologic Failure after Virologic Suppression in HIV-Infected Asian Children and Adolescents
Author(s)
Weiwei Mu
Adam W. Bartlett
Torsak Bunupuradah
Kulkanya Chokephaibulkit
Nagalingeswaran Kumarasamy
Penh Sun Ly
Rawiwan Hansudewechakul
Lam Van Nguyen
Pagakrong Lumbiganon
Tavitiya Sudjaritruk
Thahira A.Jamal Mohamed
Nik Khairulddin Nik Yusoff
Khanh Huu Truong
Viet Chau Do
Moy Siew Fong
Revathy Nallusamy
Nia Kurniati
Dewi Kumara Wati
Annette H. Sohn
Azar Kariminia
Fujie Zhang
Adam W. Bartlett
Torsak Bunupuradah
Kulkanya Chokephaibulkit
Nagalingeswaran Kumarasamy
Penh Sun Ly
Rawiwan Hansudewechakul
Lam Van Nguyen
Pagakrong Lumbiganon
Tavitiya Sudjaritruk
Thahira A.Jamal Mohamed
Nik Khairulddin Nik Yusoff
Khanh Huu Truong
Viet Chau Do
Moy Siew Fong
Revathy Nallusamy
Nia Kurniati
Dewi Kumara Wati
Annette H. Sohn
Azar Kariminia
Fujie Zhang
Other Contributor(s)
Beijing Ditan Hospital Capital Medical University
VHS Medical Centre India
National Hospital of Pediatrics Hanoi
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Capital Medical University
Kirby Institute
Faculty of Medicine, Khon Kaen University
Kuala Lumpur Hospital
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chiang Mai University
Children's Hospital 2
Children's Hospital 1
Hospital Raja Perempuan Zainab II
TREAT Asia/amfAR-The Foundation for AIDS Research
Penang Hospital
Chiangrai Prachanukroh Hospital
Hospital Likas
National Center for HIV/AIDS
VHS Medical Centre India
National Hospital of Pediatrics Hanoi
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Capital Medical University
Kirby Institute
Faculty of Medicine, Khon Kaen University
Kuala Lumpur Hospital
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Siriraj Hospital, Mahidol University
Chiang Mai University
Children's Hospital 2
Children's Hospital 1
Hospital Raja Perempuan Zainab II
TREAT Asia/amfAR-The Foundation for AIDS Research
Penang Hospital
Chiangrai Prachanukroh Hospital
Hospital Likas
National Center for HIV/AIDS
Abstract
© 2018 Wolters Kluwer Health, Inc. Background:Virologic failure is a major threat to maintaining effective combination antiretroviral therapy, especially for children in need of lifelong treatment. With efforts to expand access to HIV viral load testing, our understanding of pediatric virologic failure is evolving.Setting:An Asian cohort in 16 pediatric HIV services across 6 countries.Methods:From 2005 to 2014, patients younger than 20 years who achieved virologic suppression and had subsequent viral load testing were included. Early virologic failure was defined as a HIV RNA ≥1000 copies per milliliter within 12 months of virologic suppression, and late virologic as a HIV RNA ≥1000 copies per milliliter after 12 months following virologic suppression. Characteristics at combination antiretroviral therapy initiation and virologic suppression were described, and a competing risk time-to-event analysis was used to determine cumulative incidence of virologic failure and factors at virologic suppression associated with early and late virologic failure.Results:Of 1105 included in the analysis, 182 (17.9%) experienced virologic failure. The median age at virologic suppression was 6.9 years, and the median time to virologic failure was 24.6 months after virologic suppression. The incidence rate for a first virologic failure event was 3.3 per 100 person-years. Factors at virologic suppression associated with late virologic failure included older age, mostly rural clinic setting, tuberculosis, protease inhibitor-based regimens, and early virologic failure. No risk factors were identified for early virologic failure.Conclusions:Around 1 in 5 experienced virologic failure in our cohort after achieving virologic suppression. Targeted interventions to manage complex treatment scenarios, including adolescents, tuberculosis coinfection, and those with poor virologic control are required.