Virological failure and treatment switch after ART initiation among people living with HIV with and without routine viral load monitoring in Asia

作者：Sirinya Teeraananchai, Matthew Law, David Boettiger, Nicole De La Mata, Nikhil Gupte, Yun‐ting Lawrence Chan, Thach Ngoc Pham, Romanee Chaiwarith, Penh Sun Ly, Yu‐Jiun Chan, Sasisopin Kiertiburanakul, Suwimon Khusuwan, Fujie Zhang, Evy Yunihastuti, Nagalingeswaran Kumarasamy, Sanjay Pujari, Iskandar Azwa, I Ketut Agus Somia, Junko Tanuma, Rossana Ditangco, Jun Yong Choi, Oon Tek Ng, Cuong Duy, Yasmin Gani, Jeremy Ross, Awachana Jiamsakul, the TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia‐Pacific · 发表于：Journal of the International AIDS Society · 年份：2022 · DOI：10.1002/jia2.25989 · 被引用次数：9 · 研究领域：HIV/AIDS drug development and treatment、HIV Research and Treatment、HIV/AIDS Research and Interventions

Abstract Introduction Viral load (VL) testing is still challenging to monitor treatment responses of antiretroviral therapy (ART) for HIV treatment programme in Asia. We assessed the association between routine VL testing and virological failure (VF) and determine factors associated with switching to second‐line regimen. Methods Among 21 sites from the TREAT Asia HIV Observational Database (TAHOD), people living with HIV (PLHIV) aged ≥18 years initiating ART from 2003 to 2021 were included. We calculated the average number of VL tests per patient per year between the date of ART initiation and the most recent visit. If the median average number of VL tests was ≥ 0.80 per patient per year, the site was classified as a routine VL site. A site with a median < 0.80 was classified into the non‐routine VL sites. VF was defined as VL ≥1000 copies/ml during first‐line therapy. Factors associated with VF were analysed using generalized estimating equations with Poisson distribution. Results Of 6277 PLHIV starting ART after 2003, 3030 (48%) were from 11 routine VL testing sites and 3247 (52%) were from 10 non‐routine VL testing sites. The median follow‐up was 9 years (IQR 5–13). The median age was 35 (30–42) years; 68% were male and 5729 (91%) started non‐nucleoside reverse‐transcriptase inhibitor‐based regimen. The median pre‐ART CD4 count in PLHIV from routine VL sites was lower compared to non‐routine VL sites (144 vs. 156 cells/mm 3 , p <0.001). Overall, 1021 subsequent VF at...