HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia-Pacific region: A longitudinal cohort study

Han, Win Min and Jiamsakul, Awachana and Mohd Salleh, Nur Afiqah and Choi, Jun Yong and Huy, Bui Vu and Yunihastuti, Evy and Do, Cuong Duy and Merati, Tuti P. and Gani, Yasmin M. and Kiertiburanakul, Sasisopin and Zhang, Fujie and Chan, Yu-Jiun and Lee, Man-Po and Chaiwarith, Romanee and Ng, Oon Tek and Khusuwan, Suwimon and Ditangco, Rossana and Kumarasamy, Nagalingeswaran and Sangle, Shashikala and Ross, Jeremy and Avihingsanon, Anchalee and Evaluat, Int Epidemiology Databases (2021) HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia-Pacific region: A longitudinal cohort study. Journal of the International AIDS Society, 24 (5). ISSN 1758-2652, DOI

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INTRODUCTION Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia-Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS-defining events and mortality among PWID receiving antiretroviral therapy (ART). METHODS We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load <1000 copies/mL) were assessed. Factors associated with mean CD4 changes were analysed using repeated measures linear regression, and combined AIDS event and mortality were analysed using survival analysis. RESULTS Of 622 PWID from 12 countries in the Asia-Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre-ART CD4 count was 71 cells/mu L. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/mu L at year-10 (n = 78). Higher follow-up HIV viral load and pre-ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with >= 1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2-, 5- and 10-years following ART initiation. There were 52 new AIDS-defining events and 50 deaths during 3347 person-years of follow-up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence <95% were associated with combined new AIDS-defining event and death. CONCLUSIONS Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings.

Item Type: Article
Funders: United States Department of Health & Human Services, National Institutes of Health (NIH) - USA, NIH National Institute of Allergy & Infectious Diseases (NIAID), NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), NIH National Cancer Institute (NCI), NIH National Institute of Mental Health (NIMH), NIH National Institute on Drug Abuse (NIDA), European Commission, NIH National Heart Lung & Blood Institute (NHLBI), NIH National Institute on Alcohol Abuse & Alcoholism (NIAAA), NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS [IeDEA] [Grant No: U01AI069907], Australian Government Department of Health & Ageing, Faculty of Medicine, UNSW Sydney
Uncontrolled Keywords: People who inject drugs; Treatment outcomes; CD4 recovery; Viral suppression; Tuberculosis; HIV/AIDS; Asia-Pacific
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine
Centre of Excellence for Research in AIDS (CERiA)
Depositing User: Ms Zaharah Ramly
Date Deposited: 26 May 2022 02:01
Last Modified: 26 May 2022 02:01

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