Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program

Autor: Pupe Sudsila PhD, Sirinya Teeraananchai PhD, Sasisopin Kiertiburanakul MD, Cheewanan Lertpiriyasuwat MD, Rattaphon Triamwichanon MD, Sivaporn Gatechompol MD, Opass Putcharoen MD, Ploenchan Chetchotisakd MD, Anchalee Avihingsanon MD, PhD, Stephen J Kerr PhD, Kiat Ruxrungtham MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of the International Association of Providers of AIDS Care, Vol 22 (2023)
Druh dokumentu: article
ISSN: 2325-9582
23259582
DOI: 10.1177/23259582231220513
Popis: This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged ≥18 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load ≥1000 copies/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.
Databáze: Directory of Open Access Journals