Publication:
Effect of macrolide prophylactic therapy on AIDS-Defining conditions and HIV-Associated mortality

Issued Date

2019-04-01

Resource Type

Article

ISSN

10779450
15254135

DOI

10.1097/QAI.0000000000001933

Other identifier(s)

2-s2.0-85064989723

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.4 (2019), 436-443

Suggested Citation

Mark Kristoffer U. Pasayan, Mary Lorraine S. Mationg, David Boettiger, Wilson Lam, Fujie Zhang, Stephane Wen Wei Ku, Tuti Parwati Merati, Romanee Chaiwarith, Do Duy Cuong, Evy Yunihastuti, Sasisopin Kiertiburanakul, Nguyen Van Kinh, Anchalee Avihingsanon, Ly Penh Sun, Adeeba Kamarulzaman, Pacharee Kantipong, Nagalingeswaran Kumarasamy, Sanjay Pujari, Benedict Lim Heng Sim, Oon Tek Ng, Jun Yong Choi, Junko Tanuma, Jeremy Ross, Rossana A. Ditangco Effect of macrolide prophylactic therapy on AIDS-Defining conditions and HIV-Associated mortality. Journal of Acquired Immune Deficiency Syndromes. Vol.80, No.4 (2019), 436-443. doi:10.1097/QAI.0000000000001933 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51781

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Title

Effect of macrolide prophylactic therapy on AIDS-Defining conditions and HIV-Associated mortality

Author(s)

Mark Kristoffer U. Pasayan
 Mary Lorraine S. Mationg
 David Boettiger
 Wilson Lam
 Fujie Zhang
 Stephane Wen Wei Ku
 Tuti Parwati Merati
 Romanee Chaiwarith
 Do Duy Cuong
 Evy Yunihastuti
 Sasisopin Kiertiburanakul
 Nguyen Van Kinh
 Anchalee Avihingsanon
 Ly Penh Sun
 Adeeba Kamarulzaman
 Pacharee Kantipong
 Nagalingeswaran Kumarasamy
 Sanjay Pujari
 Benedict Lim Heng Sim
 Oon Tek Ng
 Jun Yong Choi
 Junko Tanuma
 Jeremy Ross
 Rossana A. Ditangco

Other Contributor(s)

Hospital Sungai Buloh
 Beijing Ditan Hospital Capital Medical University
 VHS Medical Centre India
 Gokila
 Bach Mai Hospital
 Universitas Udayana
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Chulalongkorn University
 Kirby Institute
 National Center for Global Health and Medicine
 Yonsei University College of Medicine
 Faculty of Medicine, Ramathibodi Hospital, Mahidol University
 Queen Elizabeth Hospital Hong Kong
 University of Malaya Medical Centre
 Veterans General Hospital-Taipei
 Tan Tock Seng Hospital
 National Hospital for Tropical Diseases
 Foundation for AIDS Research
 Institute of Infectious Diseases
 Chiangrai Prachanukroh Hospital
 National Center for HIV/AIDS
 Research Institute for Health Sciences

Abstract

© 2018 Wolters Kluwer Health, Inc. All rights reserved. Background:Mycobacterium avium complex prophylaxis is recommended for patients with advanced HIV infection. With the decrease in incidence of disseminated Mycobacterium avium complex infection and the availability of antiretroviral therapy (ART), the benefits of macrolide prophylaxis were investigated. This study examined the impact of macrolide prophylaxis on AIDS-defining conditions and HIV-associated mortality in a cohort of HIV-infected patients on ART.Methods:Patients from TREAT Asia HIV Observational Database (September 2015 data transfer) aged 18 years and older with a CD4 count <50 cells/mm3 at ART initiation were included. The effect of macrolide prophylaxis on HIV-associated mortality or AIDS-defining conditions (as a combined outcome) and HIV-associated mortality alone were evaluated using competing risk regression. Sensitivity analysis was conducted in patients with a CD4 <100 cells/mm3 at ART initiation.Results:Of 1345 eligible patients, 10.6% received macrolide prophylaxis. The rate of the combined outcome was 7.35 [95% confidence interval (CI): 6.04 to 8.95] per 100 patient-years, whereas the rate of HIV-associated mortality was 3.14 (95% CI: 2.35 to 4.19) per 100 patient-years. Macrolide use was associated with a significantly decreased risk of HIV-associated mortality (hazard ratio 0.10, 95% CI: 0.01 to 0.80, P = 0.031) but not with the combined outcome (hazard ratio 0.86, 95% CI: 0.32 to 2.229, P = 0.764). Sensitivity analyses showed consistent results among patients with a CD4 <100 cells/mm3 at ART initiation.Conclusions:Macrolide prophylaxis is associated with improved survival among Asian HIV-infected patients with low CD4 cell counts and on ART. This study suggests the increased usage and coverage of macrolide prophylaxis among people living with HIV in Asia.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/51781

Collections

Scopus 2019