Publication: Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia
Issued Date
2021-10-05
Resource Type
ISSN
15376591
Other identifier(s)
2-s2.0-85118283335
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. Vol.73, No.7 (2021), e1919-e1926
Suggested Citation
Adam W. Bartlett, Tavitiya Sudjaritruk, Thahira J. Mohamed, Suvaporn Anugulruengkit, Nagalingeswaran Kumarasamy, Wanatpreeya Phongsamart, Penh Sun Ly, Khanh Huu Truong, Lam Van Nguyen, Viet Chau Do, Pradthana Ounchanum, Thanyawee Puthanakit, Kulkanya Chokephaibulkit, Pagakrong Lumbiganon, Nia Kurniati, Nik Khairulddin Nik Yusoff, Dewi Kumara Wati, Annette H. Sohn, Azar Kariminia Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. Vol.73, No.7 (2021), e1919-e1926. doi:10.1093/cid/ciaa872 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77770
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Title
Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia
Author(s)
Adam W. Bartlett
Tavitiya Sudjaritruk
Thahira J. Mohamed
Suvaporn Anugulruengkit
Nagalingeswaran Kumarasamy
Wanatpreeya Phongsamart
Penh Sun Ly
Khanh Huu Truong
Lam Van Nguyen
Viet Chau Do
Pradthana Ounchanum
Thanyawee Puthanakit
Kulkanya Chokephaibulkit
Pagakrong Lumbiganon
Nia Kurniati
Nik Khairulddin Nik Yusoff
Dewi Kumara Wati
Annette H. Sohn
Azar Kariminia
Tavitiya Sudjaritruk
Thahira J. Mohamed
Suvaporn Anugulruengkit
Nagalingeswaran Kumarasamy
Wanatpreeya Phongsamart
Penh Sun Ly
Khanh Huu Truong
Lam Van Nguyen
Viet Chau Do
Pradthana Ounchanum
Thanyawee Puthanakit
Kulkanya Chokephaibulkit
Pagakrong Lumbiganon
Nia Kurniati
Nik Khairulddin Nik Yusoff
Dewi Kumara Wati
Annette H. Sohn
Azar Kariminia
Other Contributor(s)
Siriraj Hospital
VHS Medical Centre India
National Hospital of Pediatrics Hanoi
Universitas Udayana
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chulalongkorn University
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Chiang Mai University
National Centre for HIV/AIDS
Kuala Lumpur Women and Children Hospital
Children's Hospital 2
Children's Hospital 1
amfAR - The Foundation for AIDS Research
Hospital Raja Perempuan Zainab II
Chiangrai Prachanukroh Hospital
VHS Medical Centre India
National Hospital of Pediatrics Hanoi
Universitas Udayana
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chulalongkorn University
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Chiang Mai University
National Centre for HIV/AIDS
Kuala Lumpur Women and Children Hospital
Children's Hospital 2
Children's Hospital 1
amfAR - The Foundation for AIDS Research
Hospital Raja Perempuan Zainab II
Chiangrai Prachanukroh Hospital
Abstract
BACKGROUND: Combination antiretroviral therapy (cART) failure is a major threat to human immunodeficiency virus (HIV) programs, with implications for individual- and population-level outcomes. Adolescents with perinatally acquired HIV infection (PHIVA) should be a focus for treatment failure given their poorer outcomes compared to children and adults. METHODS: Data (2014-2018) from a regional cohort of Asian PHIVA who received at least 6 months of continuous cART were analyzed. Treatment failure was defined according to World Health Organization criteria. Descriptive analyses were used to report treatment failure and subsequent management and evaluate postfailure CD4 count and viral load trends. Kaplan-Meier survival analyses were used to compare the cumulative incidence of death and loss to follow-up (LTFU) by treatment failure status. RESULTS: A total 3196 PHIVA were included in the analysis with a median follow-up period of 3.0 years, of whom 230 (7.2%) had experienced 292 treatment failure events (161 virologic, 128 immunologic, 11 clinical) at a rate of 3.78 per 100 person-years. Of the 292 treatment failure events, 31 (10.6%) had a subsequent cART switch within 6 months, which resulted in better immunologic and virologic outcomes compared to those who did not switch cART. The 5-year cumulative incidence of death and LTFU following treatment failure was 18.5% compared to 10.1% without treatment failure. CONCLUSIONS: Improved implementation of virologic monitoring is required to realize the benefits of virologic determination of cART failure. There is a need to address issues related to accessibility to subsequent cART regimens, poor adherence limiting scope to switch regimens, and the role of antiretroviral resistance testing.