Kim, Jung Ho and Jiamsakul, Awachana and Kiertiburanakul, Sasisopin and Huy, Bui Vu and Khusuwan, Suwimon and Kumarasamy, Nagalingeswaran and Ng, Oon Tek and Ly, Penh Sun and Lee, Man-Po and Chan, Yu-Jiun and Gani, Yasmin Mohamed and Raja Azwa, Raja Iskandar Shah and Avihingsanon, Anchalee and Merati, Tuti Parwati and Pujari, Sanjay and Chaiwarith, Romanee and Zhang, Fujie and Tanuma, Junko and Do, Cuong Duy and Ditangco, Rossana and Yunihastuti, Evy and Ross, Jeremy and Choi, Jun Yong and Asia-Pacific, IeDEA (2022) Patterns and prognosis of holding regimens for people living with HIV in Asian countries. PLoS ONE, 17 (3). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0264157.
Full text not available from this repository.Abstract
The use of holding regimens for people living with HIV (PLWH) without effective antiretroviral options can have effects on outcomes and future treatment options. We aimed to investigate the use of holding regimens for PLWH in Asian countries. Data from adults enrolled in routine HIV care in IeDEA Asia-Pacific cohorts were included. Individuals were considered to be on holding regimen if they had been on combination antiretroviral therapy for at least 6 months, had two confirmed viral loads (VL) >= 1000 copies/mL, and had remained on the same medications for at least 6 months. Survival time was analyzed using Fine and Gray's competing risk regression. Factors associated with CD4 changes and VL <1000 copies/mL were analyzed using linear regression and logistic regression, respectively. A total of 425 PLWH (72.9% male; 45.2% high-income and 54.8% low-to-middle-income country) met criteria for being on a holding regimen. From high-income countries, 63.0% were on protease inhibitors (PIs); from low-to-middle-income countries, 58.4% were on non-nucleoside reverse transcriptase inhibitors (NNRTIs); overall, 4.5% were on integrase inhibitors. The combination of lamivudine, zidovudine, and efavirenz was the most commonly used single regimen (n = 46, 10.8%), followed by lamivudine, zidovudine, and nevirapine (n = 37, 8.7%). Forty-one PLWH (9.7%) died during follow-up (mortality rate 2.0 per 100 person-years). Age >50 years compared to age 31-40 years (sub-hazard ratio SHR] 3.29, 95% CI 1.45-7.43, p = 0.004), and VL >= 1000 copies/ml compared to VL <1000 copies/mL (SHR, 2.14, 95% CI 1.08-4.25, p = 0.029) were associated with increased mortality, while higher CD4 counts were protective. In our Asia regional cohort, there was a diversity of holding regimens, and the patterns of PI vs. NNRTI use differed by country income levels. Considering the high mortality rate of PLWH with holding regimen, efforts to extend accessibility to additional antiretroviral options are needed in our region.
| Item Type: | Article |
|---|---|
| Funders: | amfAR, The Foundation for AIDS Research, United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Allergy & Infectious Diseases (NIAID), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism, National Institute of Diabetes and Digestive and Kidney Diseases, Australian Government Department of Health and Ageing, United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Fogarty International Center (FIC) IeDEA; [Grant No: U01AI069907] |
| Uncontrolled Keywords: | Hiv-1-infected patients; Observational database; Antiretroviral treatment; Cell count; Resistance; Failure |
| Subjects: | Q Science > Q Science (General) T Technology > T Technology (General) |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 29 Aug 2023 07:46 |
| Last Modified: | 27 Nov 2024 01:47 |
| URI: | http://eprints.um.edu.my/id/eprint/43093 |
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