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Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE).
Martinez-Vega, Rosario; De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Ly, Penh Sun; Van Nguyen, Kinh; Merati, Tuti P; Pham, Thi Thanh; Lee, Man Po; Choi, Jun Yong; Ross, Jeremy L; Ng, Oon Tek.
Afiliação
  • Martinez-Vega R; Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.
  • De La Mata NL; The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
  • Kumarasamy N; Present address: Sydney School of Public Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.
  • Ly PS; YRG CARE Medical Centre, VHS, Chennai, India.
  • Van Nguyen K; National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia.
  • Merati TP; National Hospital for Tropical Diseases, Hanoi, Vietnam.
  • Pham TT; Faculty of Medicine, Udayana University & Sanglah Hospital, Bali, Indonesia.
  • Lee MP; Infectious Disease Department, Bach Mai Hospital, Hanoi, Vietnam.
  • Choi JY; Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.
  • Ross JL; Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.
  • Ng OT; TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
Antivir Ther ; 23(2): 167-178, 2018.
Article em En | MEDLINE | ID: mdl-28933705
BACKGROUND: The durability of first-line regimen is important to achieve long-term treatment success for the management of HIV infection. Our analysis describes the duration of sequential ART regimens and identifies the determinants leading to treatment change in HIV-positive patients initiating in Asia. METHODS: All HIV-positive adult patients initiating first-line ART in 2003-2013, from eight clinical sites among seven countries in Asia. Patient follow-up was to May 2014. Kaplan-Meier curves were used to estimate the time to second-line ART and third-line ART regimen. Factors associated with treatment durability were assessed using Cox proportional hazards model. RESULTS: A total of 16,962 patients initiated first-line ART. Of these, 4,336 patients initiated second-line ART over 38,798 person-years (pys), a crude rate of 11.2 (95% CI 10.8, 11.5) per 100 pys. The probability of being on first-line ART increased from 83.7% (95% CI 82.1, 85.1%) in 2003-2005 to 87.9% (95% CI 87.1, 88.6%) in 2010-2013. Third-line ART was initiated by 1,135 patients over 8,078 pys, a crude rate of 14.0 (95% CI 13.3, 14.9) per 100 pys. The probability of continuing second-line ART significantly increased from 64.9% (95% CI 58.5, 70.6%) in 2003-2005 to 86.2% (95% CI 84.7, 87.6%) in 2010-2013. CONCLUSIONS: Rates of discontinuation of first- and second-line regimens have decreased over the last decade in Asia. Subsequent regimens were of shorter duration compared to the first-line regimen initiated in the same year period. Lower CD4+ T-cell count and the use of suboptimal regimens were important factors associated with higher risk of treatment switch.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 Tipo de estudo: Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Antivir Ther Assunto da revista: TERAPIA POR MEDICAMENTOS / VIROLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / HIV-1 Tipo de estudo: Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Antivir Ther Assunto da revista: TERAPIA POR MEDICAMENTOS / VIROLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Singapura