| Autor: |
Alain Amstutz, Bienvenu Lengo Nsakala, Fiona Vanobberghen, Josephine Muhairwe, Tracy Renée Glass, Beatrice Achieng, Mamorena Sepeka, Katleho Tlali, Lebohang Sao, Kyaw Thin, Thomas Klimkait, Manuel Battegay, Niklaus Daniel Labhardt |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-9 (2018) |
| Druh dokumentu: |
article |
| ISSN: |
1471-2334 |
| DOI: |
10.1186/s12879-018-2979-y |
| Popis: |
Abstract Background The World Health Organization (WHO) recommends viral load (VL) measurement as the preferred monitoring strategy for HIV-infected individuals on antiretroviral therapy (ART) in resource-limited settings. The new WHO guidelines 2016 continue to define virologic failure as two consecutive VL ≥1000 copies/mL (at least 3 months apart) despite good adherence, triggering switch to second-line therapy. However, the threshold of 1000 copies/mL for defining virologic failure is based on low-quality evidence. Observational studies have shown that individuals with low-level viremia (measurable but below 1000 copies/mL) are at increased risk for accumulation of resistance mutations and subsequent virologic failure. The SESOTHO trial assesses a lower threshold for switch to second-line ART in patients with sustained unsuppressed VL. Methods In this multicenter, parallel-group, open-label, randomized controlled trial conducted in Lesotho, patients on first-line ART with two consecutive unsuppressed VL measurements ≥100 copies/mL, where the second VL is between 100 and 999 copies/mL, will either be switched to second-line ART immediately (intervention group) or not be switched (standard of care, according to WHO guidelines). The primary endpoint is viral resuppression (VL |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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