Awachana JiamsakulStephen J. KerrOon Tek NgMan Po LeeRomanee ChaiwarithEvy YunihastutiKinh Van NguyenT. T. PhamSasisopin KiertiburanakulRossana DitangcoVonthanak SaphonnBenedict L.H. SimTuti Parwati MeratiWingwai WongPacharee KantipongFujie ZhangJun Yong ChoiSanjay PujariAdeeba KamarulzamanShinichi OkaMahiran MustafaWinai RatanasuwanBoondarika PetersenMatthew LawNagalingeswaran KumarasamyC. V. MeanV. KholH. X. ZhaoN. HanP. C.K. LiW. LamY. T. ChanS. SaghayamC. EzhilarasiK. JoshiS. GaikwadA. ChitalikarD. N. WirawanF. YulianaD. ImranA. WidhaniJ. TanumaT. NishijimaS. NaJ. M. KimY. M. GaniR. DavidS. F. Syed OmarS. PonnampalavanarI. AzwaN. NordinE. UyR. BantiqueW. W. KuP. C. WuP. L. LimL. S. LeeP. S. OhnmarP. PhanuphakK. RuxrungthamA. AvihingsanonP. ChusutS. SungkanuparphL. ChumlaN. SanmeemaT. SirisanthanaW. KotarathititumJ. PraparattanapanP. KambuaR. SriondeeV. H. BuiK. V. NguyenT. H.D. NguyenT. D. NguyenD. D. CuongH. L. HaA. H. SohnN. DurierD. A. CooperD. C. BoettigerUniversity of New South Wales (UNSW) AustraliaThe HIV Netherlands Australia Thailand Research CollaborationAcademic Medical Centre, University of AmsterdamTan Tock Seng HospitalQueen Elizabeth Hospital Hong KongChiang Mai UniversityUniversity of Indonesia, RSUPN Dr. Cipto MangunkusumoNational Hospital for Tropical DiseasesBach Mai HospitalMahidol UniversityGokilaDermatology and STDs and University of Health SciencesHospital Sungai BulohUniversitas UdayanaVeterans General Hospital-TaipeiChiangrai Prachanukroh HospitalBeijing Ditan HospitalYonsei University College of MedicineInstitute of Infectious DiseasesUniversity of Malaya Medical CentreNational Center for Global Health and MedicineHospital Raja Perempuan Zainab IIamfAR - The Foundation for AIDS ResearchVHS Medical Centre IndiaResearch Institute for Health Sciences2018-12-112019-03-142018-12-112019-03-142016-05-01Tropical Medicine and International Health. Vol.21, No.5 (2016), 662-67413653156136022762-s2.0-84963722410https://repository.li.mahidol.ac.th/handle/123456789/40852© 2016 John Wiley & Sons Ltd. Objectives: Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Methods: Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P < 0.10 in univariable analyses were included in multivariable analyses, where P < 0.05 was considered statistically significant. Results: Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). Conclusions: Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption.Mahidol UniversityImmunology and MicrobiologyArticleSCOPUS10.1111/tmi.12690