Publication:
Short Communication: Impact of Viral Load Use on Treatment Switch in Perinatally HIV-Infected Children in Asia

Issued Date

2017-03-01

Resource Type

Article

ISSN

19318405
08892229

DOI

10.1089/aid.2016.0039

Other identifier(s)

2-s2.0-85014491256

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

AIDS Research and Human Retroviruses. Vol.33, No.3 (2017), 230-233

Suggested Citation

Thahira Jamal Mohamed, Sirinya Teeraananchai, Stephen Kerr, Wanatpreeya Phongsamart, Nik Khairulddin Nik Yusoff, Rawiwan Hansudewechakul, Penh Sun Ly, Lam Van Nguyen, Tavitiya Sudjaritruk, Pagakrong Lumbiganon, Viet Chau Do, Nia Kurniati, Nagalingeswaran Kumarasamy, Dewi Kumara Wati, Moy Siew Fong, Revathy Nallusamy, Azar Kariminia, Annette H. Sohn Short Communication: Impact of Viral Load Use on Treatment Switch in Perinatally HIV-Infected Children in Asia. AIDS Research and Human Retroviruses. Vol.33, No.3 (2017), 230-233. doi:10.1089/aid.2016.0039 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/42842

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Title

Short Communication: Impact of Viral Load Use on Treatment Switch in Perinatally HIV-Infected Children in Asia

Author(s)

Thahira Jamal Mohamed
 Sirinya Teeraananchai
 Stephen Kerr
 Wanatpreeya Phongsamart
 Nik Khairulddin Nik Yusoff
 Rawiwan Hansudewechakul
 Penh Sun Ly
 Lam Van Nguyen
 Tavitiya Sudjaritruk
 Pagakrong Lumbiganon
 Viet Chau Do
 Nia Kurniati
 Nagalingeswaran Kumarasamy
 Dewi Kumara Wati
 Moy Siew Fong
 Revathy Nallusamy
 Azar Kariminia
 Annette H. Sohn

Other Contributor(s)

Kuala Lumpur Hospital
 The HIV Netherlands Australia Thailand Research Collaboration
 Mahidol University
 Hospital Raja Perempuan Zainab II
 Chiangrai Prachanukroh Hospital
 National Center for HIV/AIDS
 National Hospital of Pediatrics Hanoi
 Chiang Mai University
 Khon Kaen University
 Children's Hospital 2
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 VHS Medical Centre India
 Universitas Udayana
 Hospital Likas
 Penang Hospital
 University of New South Wales (UNSW) Australia
 TREAT Asia/amfAR-The Foundation for AIDS Research

Abstract

© 2017, Mary Ann Liebert, Inc. 2017. We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. Data from a regional cohort of 16 clinical programs in six Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and ≥1 of the following: (1) reported treatment failure by local criteria, (2) switch of ≥1 additional drug, or (3) a preceding HIV VL ≥1,000 copies/ml. Routine VL was having ≥1 test after ≥24 weeks of ART and ≥1 time/year thereafter. Factors associated with time to switch were evaluated with death and loss to follow-up as competing risks. A total of 2,398 children were included in this analysis. At ART initiation, the median (interquartile range) age was 6.0 (3.3-8.9) years, more than half had WHO stage 3 or 4, the median CD4 was 189 (47-456) cells/mm3, 93% were on NNRTI-based first-line ART, and 34% had routine VL monitoring. Treatment switch occurred in 17.6% of patients, at a median of 35 (22-49) months. After adjusting for country, sex, first ART regimen, and CD4% at ART initiation, children with routine VL monitoring were 1.46 (95% confidence interval 1.11-1.93) times more likely to be switched (p = .007). Scale-up of VL testing will lead to earlier identification of treatment failure, and it can help guide earlier switches to prevent resistance.

Keyword(s)

Immunology and Microbiology

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/42842

Collections

Scopus 2016-2017