Publication:
Early and Late Virologic Failure after Virologic Suppression in HIV-Infected Asian Children and Adolescents

dc.contributor.authorWeiwei Muen_US
dc.contributor.authorAdam W. Bartletten_US
dc.contributor.authorTorsak Bunupuradahen_US
dc.contributor.authorKulkanya Chokephaibulkiten_US
dc.contributor.authorNagalingeswaran Kumarasamyen_US
dc.contributor.authorPenh Sun Lyen_US
dc.contributor.authorRawiwan Hansudewechakulen_US
dc.contributor.authorLam Van Nguyenen_US
dc.contributor.authorPagakrong Lumbiganonen_US
dc.contributor.authorTavitiya Sudjaritruken_US
dc.contributor.authorThahira A.Jamal Mohameden_US
dc.contributor.authorNik Khairulddin Nik Yusoffen_US
dc.contributor.authorKhanh Huu Truongen_US
dc.contributor.authorViet Chau Doen_US
dc.contributor.authorMoy Siew Fongen_US
dc.contributor.authorRevathy Nallusamyen_US
dc.contributor.authorNia Kurniatien_US
dc.contributor.authorDewi Kumara Watien_US
dc.contributor.authorAnnette H. Sohnen_US
dc.contributor.authorAzar Kariminiaen_US
dc.contributor.authorFujie Zhangen_US
dc.contributor.otherBeijing Ditan Hospital Capital Medical Universityen_US
dc.contributor.otherVHS Medical Centre Indiaen_US
dc.contributor.otherNational Hospital of Pediatrics Hanoien_US
dc.contributor.otherUniversitas Udayanaen_US
dc.contributor.otherUniversity of Indonesia, RSUPN Dr. Cipto Mangunkusumoen_US
dc.contributor.otherCapital Medical Universityen_US
dc.contributor.otherKirby Instituteen_US
dc.contributor.otherFaculty of Medicine, Khon Kaen Universityen_US
dc.contributor.otherKuala Lumpur Hospitalen_US
dc.contributor.otherThe HIV Netherlands Australia Thailand Research Collaborationen_US
dc.contributor.otherFaculty of Medicine, Siriraj Hospital, Mahidol Universityen_US
dc.contributor.otherChiang Mai Universityen_US
dc.contributor.otherChildren's Hospital 2en_US
dc.contributor.otherChildren's Hospital 1en_US
dc.contributor.otherHospital Raja Perempuan Zainab IIen_US
dc.contributor.otherTREAT Asia/amfAR-The Foundation for AIDS Researchen_US
dc.contributor.otherPenang Hospitalen_US
dc.contributor.otherChiangrai Prachanukroh Hospitalen_US
dc.contributor.otherHospital Likasen_US
dc.contributor.otherNational Center for HIV/AIDSen_US
dc.date.accessioned2020-01-27T10:04:21Z
dc.date.available2020-01-27T10:04:21Z
dc.date.issued2019-03-01en_US
dc.description.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.en_US
dc.identifier.citationJournal of Acquired Immune Deficiency Syndromes. Vol.80, No.3 (2019), 308-315en_US
dc.identifier.doi10.1097/QAI.0000000000001921en_US
dc.identifier.issn10779450en_US
dc.identifier.issn15254135en_US
dc.identifier.other2-s2.0-85061499788en_US
dc.identifier.urihttps://repository.li.mahidol.ac.th/handle/20.500.14594/51846
dc.rightsMahidol Universityen_US
dc.rights.holderSCOPUSen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061499788&origin=inwarden_US
dc.subjectMedicineen_US
dc.titleEarly and Late Virologic Failure after Virologic Suppression in HIV-Infected Asian Children and Adolescentsen_US
dc.typeArticleen_US
dspace.entity.typePublication
mu.datasource.scopushttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061499788&origin=inwarden_US

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