Publication:
Factors associated with pre-treatment HIV RNA: Application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings

Issued Date

2017-05-05

Resource Type

Article

ISSN

17426405

DOI

10.1186/s12981-017-0151-1

Other identifier(s)

2-s2.0-85018734109

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

AIDS Research and Therapy. Vol.14, No.1 (2017)

Suggested Citation

Sasisopin Kiertiburanakul, David Boettiger, Oon Tek Ng, Nguyen Kinh, Tuti Parwati Merati, Anchalee Avihingsanon, Wing Wai Wong, Man Po Lee, Romanee Chaiwarith, Adeeba Kamarulzaman, Pacharee Kantipong, Fujie Zhang, Jun Yong Choi, Nagalingeswaran Kumarasamy, Rossana Ditangco, Do Duy Cuong, Shinichi Oka, Benedict Lim Heng Sim, Winai Ratanasuwan, Penh Sun Ly, Evy Yunihastuti, Sanjay Pujari, Jeremy L. Ross, Matthew Law, Somnuek Sungkanuparph, V. Khol, F. J. Zhang, 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, E. Uy, R. Bantique, W. W. Ku, P. C. Wu, P. L. Lim, L. S. Lee, P. S. Ohnmar, S. Gatechompol, P. Phanuphak, C. Phadungphon, L. Chumla, N. Sanmeema, T. Sirisanthana, W. Kotarathititum, J. Praparattanapan, P. Kambua, R. Sriondee, K. V. Nguyen, H. V. Bui, D. T.H. Nguyen, D. T. Nguyen, N. V. An, N. T. Luan, A. H. Sohn, B. Petersen, D. A. Cooper, A. Jiamsakul, D. C. Boettiger Factors associated with pre-treatment HIV RNA: Application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings. AIDS Research and Therapy. Vol.14, No.1 (2017). doi:10.1186/s12981-017-0151-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/41907

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Title

Factors associated with pre-treatment HIV RNA: Application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings

Author(s)

Sasisopin Kiertiburanakul
 David Boettiger
 Oon Tek Ng
 Nguyen Kinh
 Tuti Parwati Merati
 Anchalee Avihingsanon
 Wing Wai Wong
 Man Po Lee
 Romanee Chaiwarith
 Adeeba Kamarulzaman
 Pacharee Kantipong
 Fujie Zhang
 Jun Yong Choi
 Nagalingeswaran Kumarasamy
 Rossana Ditangco
 Do Duy Cuong
 Shinichi Oka
 Benedict Lim Heng Sim
 Winai Ratanasuwan
 Penh Sun Ly
 Evy Yunihastuti
 Sanjay Pujari
 Jeremy L. Ross
 Matthew Law
 Somnuek Sungkanuparph
 V. Khol
 F. J. Zhang
 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
 E. Uy
 R. Bantique
 W. W. Ku
 P. C. Wu
 P. L. Lim
 L. S. Lee
 P. S. Ohnmar
 S. Gatechompol
 P. Phanuphak
 C. Phadungphon
 L. Chumla
 N. Sanmeema
 T. Sirisanthana
 W. Kotarathititum
 J. Praparattanapan
 P. Kambua
 R. Sriondee
 K. V. Nguyen
 H. V. Bui
 D. T.H. Nguyen
 D. T. Nguyen
 N. V. An
 N. T. Luan
 A. H. Sohn
 B. Petersen
 D. A. Cooper
 A. Jiamsakul
 D. C. Boettiger

Other Contributor(s)

Mahidol University
 University of New South Wales (UNSW) Australia
 Tan Tock Seng Hospital
 National Hospital of Tropical Diseases
 Universitas Udayana
 The HIV Netherlands Australia Thailand Research Collaboration
 Veterans General Hospital-Taipei
 Queen Elizabeth Hospital Hong Kong
 Research Institute for Health Sciences
 University of Malaya Medical Centre
 Chiangrai Prachanukroh Hospital
 Beijing Ditan Hospital
 Yonsei University College of Medicine
 VHS Medical Centre India
 Gokila
 Bach Mai Hospital
 National Center for Global Health and Medicine
 Hospital Sungai Buloh
 University of Health Sciences
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Institute of Infectious Diseases
 Foundation for AIDS Research
 National Hospital for Tropical Diseases

Abstract

© 2017 The Author(s). Background: Abacavir and rilpivirine are alternative antiretroviral drugs for treatment-naïve HIV-infected patients. However, both drugs are only recommended for the patients who have pre-treatment HIV RNA <100,000 copies/mL. In resource-limited settings, pre-treatment HIV RNA is not routinely performed and not widely available. The aims of this study are to determine factors associated with pre-treatment HIV RNA <100,000 copies/mL and to construct a model to predict this outcome. Methods: HIV-infected adults enrolled in the TREAT Asia HIV Observational Database were eligible if they had an HIV RNA measurement documented at the time of ART initiation. The dataset was randomly split into a derivation data set (75% of patients) and a validation data set (25%). Factors associated with pre-treatment HIV RNA <100,000 copies/mL were evaluated by logistic regression adjusted for study site. A prediction model and prediction scores were created. Results: A total of 2592 patients were enrolled for the analysis. Median [interquartile range (IQR)] age was 35.8 (29.9-42.5) years; CD4 count was 147 (50-248) cells/mm3; and pre-treatment HIV RNA was 100,000 (34,045-301,075) copies/mL. Factors associated with pre-treatment HIV RNA <100,000 copies/mL were age <30 years [OR 1.40 vs. 41-50 years; 95% confidence interval (CI) 1.10-1.80, p = 0.01], body mass index >30 kg/m2 (OR 2.4 vs. <18.5 kg/m2; 95% CI 1.1-5.1, p = 0.02), anemia (OR 1.70; 95% CI 1.40-2.10, p < 0.01), CD4 count >350 cells/mm3 (OR 3.9 vs. <100 cells/mm3; 95% CI 2.0-4.1, p < 0.01), total lymphocyte count >2000 cells/mm3 (OR 1.7 vs. <1000 cells/mm3; 95% CI 1.3-2.3, p < 0.01), and no prior AIDS-defining illness (OR 1.8; 95% CI 1.5-2.3, p < 0.01). Receiver-operator characteristic (ROC) analysis yielded area under the curve of 0.70 (95% CI 0.67-0.72) among derivation patients and 0.69 (95% CI 0.65-0.74) among validation patients. A cut off score >25 yielded the sensitivity of 46.7%, specificity of 79.1%, positive predictive value of 67.7%, and negative predictive value of 61.2% for prediction of pre-treatment HIV RNA <100,000 copies/mL among derivation patients. Conclusion: A model prediction for pre-treatment HIV RNA <100,000 copies/mL produced an area under the ROC curve of 0.70. A larger sample size for prediction model development as well as for model validation is warranted.

Keyword(s)

Biochemistry, Genetics and Molecular Biology
 Immunology and Microbiology

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/41907

Collections

Scopus 2016-2017