Back to Search Start Over

Short Communication: Impact of Viral Load Use on Treatment Switch in Perinatally HIV-Infected Children in Asia.

Authors :
Jamal Mohamed, Thahira
Teeraananchai, Sirinya
Kerr, Stephen
Phongsamart, Wanatpreeya
Nik Yusoff, Nik Khairulddin
Hansudewechakul, Rawiwan
Ly, Penh Sun
Nguyen, Lam Van
Sudjaritruk, Tavitiya
Lumbiganon, Pagakrong
Do, Viet Chau
Kurniati, Nia
Kumarasamy, Nagalingeswaran
Wati, Dewi Kumara
Fong, Moy Siew
Nallusamy, Revathy
Kariminia, Azar
Sohn, Annette H.
Source :
AIDS Research & Human Retroviruses; Mar2017, Vol. 33 Issue 3, p230-233, 4p
Publication Year :
2017

Abstract

We sought to assess the impact of routine HIV viral load (VL) monitoring on the incidence of switching from a first- to a second-line antiretroviral therapy (ART) regimen, and to describe factors associated with switch. Data from a regional cohort of 16 clinical programs in six Asian countries were analyzed. Second-line switch was defined as a change from a non-nucleoside reverse transcriptase inhibitor (NNRTI) to a protease inhibitor (PI) or vice versa, and ≥1 of the following: (1) reported treatment failure by local criteria, (2) switch of ≥1 additional drug, or (3) a preceding HIV VL ≥1,000 copies/ml. Routine VL was having ≥1 test after ≥24 weeks of ART and ≥1 time/year thereafter. Factors associated with time to switch were evaluated with death and loss to follow-up as competing risks. A total of 2,398 children were included in this analysis. At ART initiation, the median (interquartile range) age was 6.0 (3.3-8.9) years, more than half had WHO stage 3 or 4, the median CD4 was 189 (47-456) cells/mm<superscript>3</superscript>, 93% were on NNRTI-based first-line ART, and 34% had routine VL monitoring. Treatment switch occurred in 17.6% of patients, at a median of 35 (22-49) months. After adjusting for country, sex, first ART regimen, and CD4% at ART initiation, children with routine VL monitoring were 1.46 (95% confidence interval 1.11-1.93) times more likely to be switched ( p = .007). Scale-up of VL testing will lead to earlier identification of treatment failure, and it can help guide earlier switches to prevent resistance. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
08892229
Volume :
33
Issue :
3
Database :
Supplemental Index
Journal :
AIDS Research & Human Retroviruses
Publication Type :
Academic Journal
Accession number :
121501947
Full Text :
https://doi.org/10.1089/aid.2016.0039