Publication:
Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV

Issued Date

2019-06-01

Resource Type

Article

ISSN

17582652

DOI

10.1002/jia2.25312

Other identifier(s)

2-s2.0-85067538083

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of the International AIDS Society. Vol.22, No.6 (2019)

Suggested Citation

Tavitiya Sudjaritruk, David C. Boettiger, Lam Van Nguyen, Thahira J. Mohamed, Dewi K. Wati, Torsak Bunupuradah, Rawiwan Hansudewechakul, Penh S. Ly, Pagakrong Lumbiganon, Revathy A. Nallusamy, Moy S. Fong, Kulkanya Chokephaibulkit, Nik K. Nik Yusoff, Khanh H. Truong, Viet C. Do, Annette H. Sohn, Virat Sirisanthana, J. Tucker, N. Kumarasamy, E. Chandrasekaran, D. Vedaswari, I. B. Ramajaya, N. Kurniati, D. Muktiarti, M. Lim, F. Daut, P. Mohamad, M. R. Drawis, K. C. Chan, L. Aurpibul, P. Ounchanum, S. Denjanta, A. Kongphonoi, P. Kosalaraksa, P. Tharnprisan, T. Udomphanit, G. Jourdain, T. Puthanakit, S. Anugulruengkit, W. Jantarabenjakul, R. Nadsasarn, K. Lapphra, W. Phongsamart, S. Sricharoenchai, Q. T. Du, C. H. Nguyen, T. M. Ha, V. T. An, D. T.K. Khu, A. N. Pham, L. T. Nguyen, O. N. Le, Ho Chi, J. L. Ross, T. Suwanlerk, M. G. Law, A. Kariminia Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV. Journal of the International AIDS Society. Vol.22, No.6 (2019). doi:10.1002/jia2.25312 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51636

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Title

Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV

Author(s)

Tavitiya Sudjaritruk
 David C. Boettiger
 Lam Van Nguyen
 Thahira J. Mohamed
 Dewi K. Wati
 Torsak Bunupuradah
 Rawiwan Hansudewechakul
 Penh S. Ly
 Pagakrong Lumbiganon
 Revathy A. Nallusamy
 Moy S. Fong
 Kulkanya Chokephaibulkit
 Nik K. Nik Yusoff
 Khanh H. Truong
 Viet C. Do
 Annette H. Sohn
 Virat Sirisanthana
 J. Tucker
 N. Kumarasamy
 E. Chandrasekaran
 D. Vedaswari
 I. B. Ramajaya
 N. Kurniati
 D. Muktiarti
 M. Lim
 F. Daut
 P. Mohamad
 M. R. Drawis
 K. C. Chan
 L. Aurpibul
 P. Ounchanum
 S. Denjanta
 A. Kongphonoi
 P. Kosalaraksa
 P. Tharnprisan
 T. Udomphanit
 G. Jourdain
 T. Puthanakit
 S. Anugulruengkit
 W. Jantarabenjakul
 R. Nadsasarn
 K. Lapphra
 W. Phongsamart
 S. Sricharoenchai
 Q. T. Du
 C. H. Nguyen
 T. M. Ha
 V. T. An
 D. T.K. Khu
 A. N. Pham
 L. T. Nguyen
 O. N. Le
 Ho Chi
 J. L. Ross
 T. Suwanlerk
 M. G. Law
 A. Kariminia

Other Contributor(s)

National Hospital of Pediatrics Hanoi
 Universitas Udayana
 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
 National Center for HIV/AIDS
 Children's Hospital 1
 Foundation for AIDS Research
 Chiangrai Prachanukroh Hospital
 Hospital Likas
 Hospital Raja Perempuan Zainab II
 Penang Hospital

Abstract

© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. Introduction: Recommendations on the optimal frequency of plasma viral load (pVL) monitoring in children living with HIV (CLWH) who are stable on combination antiretroviral therapy (cART) are inconsistent. This study aimed to determine the impact of annual versus semi-annual pVL monitoring on treatment outcomes in Asian CLWH. Methods: Data on children with perinatally acquired HIV aged <18 years on first-line, non-nucleoside reverse transcriptase inhibitor-based cART with viral suppression (two consecutive pVL <400 copies/mL over a six-month period) were included from a regional cohort study; those exposed to prior mono- or dual antiretroviral treatment were excluded. Frequency of pVL monitoring was determined at the site-level based on the median rate of pVL measurement: annual 0.75 to 1.5, and semi-annual >1.5 tests/patient/year. Treatment failure was defined as virologic failure (two consecutive pVL >1000 copies/mL), change of antiretroviral drug class, or death. Baseline was the date of the second consecutive pVL <400 copies/mL. Competing risk regression models were used to identify predictors of treatment failure. Results: During January 2008 to March 2015, there were 1220 eligible children from 10 sites that performed at least annual pVL monitoring, 1042 (85%) and 178 (15%) were from sites performing annual (n = 6) and semi-annual pVL monitoring (n = 4) respectively. Pre-cART, 675 children (55%) had World Health Organization clinical stage 3 or 4, the median nadir CD4 percentage was 9%, and the median pVL was 5.2 log10 copies/mL. At baseline, the median age was 9.2 years, 64% were on nevirapine-based regimens, the median cART duration was 1.6 years, and the median CD4 percentage was 26%. Over the follow-up period, 258 (25%) CLWH with annual and 40 (23%) with semi-annual pVL monitoring developed treatment failure, corresponding to incidence rates of 5.4 (95% CI: 4.8 to 6.1) and 4.3 (95% CI: 3.1 to 5.8) per 100 patient-years of follow-up respectively (p = 0.27). In multivariable analyses, the frequency of pVL monitoring was not associated with treatment failure (adjusted hazard ratio: 1.12; 95% CI: 0.80 to 1.59). Conclusions: Annual compared to semi-annual pVL monitoring was not associated with an increased risk of treatment failure in our cohort of virally suppressed children with perinatally acquired HIV on first-line NNRTI-based cART.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/51636

Collections

Scopus 2019