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Jiamsakul A, Azwa I, Zhang F, et al. Treatment modification after second-line failure among people living with HIV in the Asia-Pacific. Antivir Ther. 2020;25(7):377-387doi: 10.3851/IMP3388.
Jiamsakul, A., Azwa, I., Zhang, F., Yunihastuti, E., Ditangco, R., Kumarasamy, N., Ng, O. T., Chan, Y. J., Ly, P. S., Choi, J. Y., Lee, M. P., Pujari, S., Kiertiburanakul, S., Chaiwarith, R., Merati, T. P., Sangle, S., Khusuwan, S., Sim, B. L., Avihingsanon, A., Duy, C., Tanuma, J., Ross, J., Law, M., & Asia-Pacific, T. A. H. O. D. O. I. (2020). Treatment modification after second-line failure among people living with HIV in the Asia-Pacific. Antiviral therapy, 25(7), 377-387. https://doi.org/10.3851/IMP3388
Jiamsakul, Awachana, et al. "Treatment modification after second-line failure among people living with HIV in the Asia-Pacific." Antiviral therapy vol. 25,7 (2020): 377-387. doi: https://doi.org/10.3851/IMP3388
Jiamsakul A, Azwa I, Zhang F, Yunihastuti E, Ditangco R, Kumarasamy N, Ng OT, Chan YJ, Ly PS, Choi JY, Lee MP, Pujari S, Kiertiburanakul S, Chaiwarith R, Merati TP, Sangle S, Khusuwan S, Sim BL, Avihingsanon A, Duy C, Tanuma J, Ross J, Law M, Asia-Pacific TAHODOI. Treatment modification after second-line failure among people living with HIV in the Asia-Pacific. Antivir Ther. 2020;25(7):377-387. doi: 10.3851/IMP3388. PMID: 33843656; PMCID: PMC8275121.
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Antivir Ther. 2020;25(7):377-387. doi: 10.3851/IMP3388.

Treatment modification after second-line failure among people living with HIV in the Asia-Pacific.

Antiviral therapy

Awachana Jiamsakul, Iskandar Azwa, Fujie Zhang, Evy Yunihastuti, Rossana Ditangco, Nagalingeswaran Kumarasamy, Oon Tek Ng, Yu-Jiun Chan, Penh Sun Ly, Jun Yong Choi, Man-Po Lee, Sanjay Pujari, Sasisopin Kiertiburanakul, Romanee Chaiwarith, Tuti Parwati Merati, Shashikala Sangle, Suwimon Khusuwan, Benedict Lh Sim, Anchalee Avihingsanon, Cuong Duy, Junko Tanuma, Jeremy Ross, Matthew Law, Treat Asia Hiv Observational Database Of IeDEA Asia-Pacific

Affiliations

  1. The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
  2. University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
  3. Beijing Ditan Hospital, Capital Medical University, Beijing, China.
  4. Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  5. Research Institute for Tropical Medicine, Manila, Philippines.
  6. Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), The Voluntary Health Services (VHS), Chennai, India.
  7. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore.
  8. Taipei Veterans General Hospital, Taipei, Taiwan.
  9. National Center for HIV/AIDS, Dermatology & STDs, and University of Health Sciences, Phnom Penh, Cambodia.
  10. Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
  11. Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong SAR, China.
  12. Institute of Infectious Diseases, Pune, India.
  13. Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
  14. Research Institute for Health Sciences, Chiang Mai, Thailand.
  15. Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
  16. BJ Government Medical College and Sassoon General Hospital, Pune, India.
  17. Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
  18. Hospital Sungai Buloh, Sungai Buloh, Malaysia.
  19. HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  20. Bach Mai Hospital, Hanoi, Vietnam.
  21. National Center for Global Health and Medicine, Tokyo, Japan.
  22. TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.

PMID: 33843656 PMCID: PMC8275121 DOI: 10.3851/IMP3388

Abstract

BACKGROUND: The World Health Organization recommends continuation with the failing second-line regimen if third-line option is not available. We investigated treatment outcomes among people living with HIV in Asia who continued with failing second-line regimens compared with those who had treatment modifications after failure.

METHODS: Treatment modification was defined as a change of two antiretrovirals, a drug class change or treatment interruption (TI), all for >14 days. We assessed factors associated with CD4 changes and undetectable viral load (UVL <1,000 copies/ml) at 1 year after second-line failure using linear and logistic regression, respectively. Survival time was analysed using competing risk regression.

RESULTS: Of the 328 patients who failed second-line ART in our cohorts, 208 (63%) had a subsequent treatment modification. Compared with those who continued the failing regimen, the average CD4 cell increase was higher in patients who had a modification without TI (difference =77.5, 95% CI 35.3, 119.7) while no difference was observed among those with TI (difference =-5.3, 95% CI -67.3, 56.8). Compared with those who continued the failing regimen, the odds of achieving UVL was lower in patients with TI (OR=0.18, 95% CI 0.06, 0.60) and similar among those who had a modification without TI (OR=1.97, 95% CI 0.95, 4.10), with proportions of UVL 60%, 22% and 75%, respectively. Survival time was not affected by treatment modifications.

CONCLUSIONS: CD4 cell improvements were observed in those who had treatment modification without TI compared with those on the failing regimen. When no other options are available, maintaining the same failing ART combination provided better VL control than interrupting treatment.

References

  1. J Acquir Immune Defic Syndr. 2020 May 1;84(1):107-113 - PubMed
  2. Trop Med Int Health. 2018 Oct;23(10):1075-1083 - PubMed
  3. AIDS Res Ther. 2018 Apr 10;15(1):10 - PubMed
  4. AIDS. 2012 May 15;26(8):929-38 - PubMed
  5. BMC Infect Dis. 2017 Aug 22;17(1):582 - PubMed
  6. Trop Med Int Health. 2016 Sep;21(9):1131-7 - PubMed
  7. AIDS. 2014 Sep 10;28(14):2097-107 - PubMed
  8. AIDS Res Hum Retroviruses. 2016 Aug;32(8):772-81 - PubMed
  9. HIV Med. 2010 Jan;11(1):31-9 - PubMed
  10. PLoS One. 2020 Sep 28;15(9):e0239191 - PubMed
  11. Glob Health Action. 2017;10(1):1290916 - PubMed
  12. PLoS One. 2014 Sep 15;9(9):e106887 - PubMed
  13. Antivir Ther. 2016;21(6):517-527 - PubMed
  14. PLoS One. 2019 Nov 21;14(11):e0225631 - PubMed
  15. J Acquir Immune Defic Syndr. 2019 Jan 1;80(1):73-78 - PubMed
  16. Glob Health Action. 2014 Jul 30;7:24861 - PubMed
  17. PLoS One. 2020 Mar 2;15(3):e0228601 - PubMed
  18. AIDS Patient Care STDS. 2017 May;31(5):205-212 - PubMed
  19. Am J Pathol. 2018 Mar;188(3):683-695 - PubMed
  20. AIDS Care. 2018 Jul;30(7):863-870 - PubMed
  21. Open Forum Infect Dis. 2018 Feb 02;5(2):ofy005 - PubMed
  22. Lancet HIV. 2019 Nov;6(11):e750-e759 - PubMed
  23. Lancet HIV. 2019 Sep;6(9):e588-e600 - PubMed

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