Publication:
Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD

1

Issued Date

2016-05-01

Resource Type

Article

ISSN

13653156
13602276

DOI

10.1111/tmi.12690

Other identifier(s)

2-s2.0-84963722410

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Tropical Medicine and International Health. Vol.21, No.5 (2016), 662-674

Suggested Citation

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 Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD. Tropical Medicine and International Health. Vol.21, No.5 (2016), 662-674. doi:10.1111/tmi.12690 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/40852

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Title

Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD

Author(s)

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

Other Contributor(s)

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

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.

Keyword(s)

Immunology and Microbiology

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/40852

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Scopus 2016-2017