Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program
Issued Date
2023-01-01
Resource Type
ISSN
23259574
eISSN
23259582
Scopus ID
2-s2.0-85180686823
Pubmed ID
38115729
Journal Title
Journal of the International Association of Providers of AIDS Care
Volume
22
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the International Association of Providers of AIDS Care Vol.22 (2023)
Suggested Citation
Sudsila P., Teeraananchai S., Kiertiburanakul S., Lertpiriyasuwat C., Triamwichanon R., Gatechompol S., Putcharoen O., Chetchotisakd P., Avihingsanon A., Kerr S.J., Ruxrungtham K. Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program. Journal of the International Association of Providers of AIDS Care Vol.22 (2023). doi:10.1177/23259582231220513 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95528
Title
Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program
Author's Affiliation
National Health Security Office
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Kasetsart University
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Thailand Ministry of Public Health
Faculty of Medicine, Chulalongkorn University
The Kirby Institute
Faculty of Medicine, Khon Kaen University
Kasetsart University
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Thailand Ministry of Public Health
Faculty of Medicine, Chulalongkorn University
Corresponding Author(s)
Other Contributor(s)
Abstract
This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged ≥18 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load ≥1000 copies/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.