Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program-Reference-Cited by-同舟云学术

Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program

Published:2023-01 Issue: Volume:22 Page:
ISSN:2325-9582
Container-title:Journal of the International Association of Providers of AIDS Care (JIAPAC)
language:en
Short-container-title:J Int Assoc Provid AIDS Care

Author:

Sudsila Pupe¹,Teeraananchai Sirinya²,Kiertiburanakul Sasisopin³^ORCID,Lertpiriyasuwat Cheewanan⁴^ORCID,Triamwichanon Rattaphon⁵,Gatechompol Sivaporn⁶⁷,Putcharoen Opass⁸,Chetchotisakd Ploenchan⁹,Avihingsanon Anchalee⁶⁷,Kerr Stephen J¹⁶¹⁰^ORCID,Ruxrungtham Kiat⁶¹¹

Affiliation:

1. Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

2. Department of Statistics, Faculty of Science, Kasetsart University, Bangkok, Thailand

3. Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

4. Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand

5. National Health Security Office, Nonthaburi, Thailand

6. HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand

7. Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

8. Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

9. Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Khon Kaen University, Srinagarind Hospital, Khon Kaen, Thailand

10. The Kirby Institute, University of New South Wales, Sydney, Australia

11. Centre of Excellence in Vaccine Research and Development (Chula VRC), and School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

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.

Funder

Second Century Fund (C2F) Chulalongkorn University

amfAR, The Foundation for AIDS Research

Publisher

SAGE Publications

Subject

Infectious Diseases,Dermatology,Immunology

Link

http://journals.sagepub.com/doi/pdf/10.1177/23259582231220513

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