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Publikasi Scopus 926 artikel (Per 14 Maret 2022)
Publikasi Scopus 926 artikel (Per 14 Maret 2022)
Identification, Management, and Outcomes of Combination Antiretroviral Treatment Failure in Adolescents With Perinatal Human Immunodeficiency Virus Infection in Asia
2021
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
73
7
e1919
e1926
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85118283335&doi=10.1093%2fcid%2fciaa872&partnerID=40&md5=7af8cf47bd95718a30d3277b5797f9ba
Kirby Institute, University of New South Wales, Sydney, Australia; Department of Pediatrics, Faculty of Medicine, Research Institute for Health Sciences, Chiang Mai UniversityChiang Mai, Thailand; Women and Children Hospital Kuala LumpurKuala Lumpur, Malaysia; Department of Pediatrics, Faculty of Medicine, Chulalongkorn UniversityBangkok, Thailand; Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn UniversityBangkok, Thailand; Chennai Antiviral Research and Treatment Clinical Research Site, VHS-Infectious Diseases Medical Centre, Voluntary Health Services, Chennai, India; Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol UniversityBangkok, Thailand; National Centre for HIV/AIDS, Dermatology and Sexually Transmitted DiseasesPhnom Penh, Cambodia; Children's Hospital 1, Ho Chi Minh City, Viet Nam; National Hospital of PediatricsHanoi, Viet Nam; Children's Hospital 2, Ho Chi Minh City, Viet Nam; Chiangrai Prachanukroh HospitalChiang Rai, Thailand; Department of Pediatrics, Faculty of Medicine, Khon Kaen UniversityKhon Kaen, Thailand; Cipto Mangunkusumo-Faculty of Medicine Universitas IndonesiaJakarta, Indonesia; Hospital Raja Perempuan Zainab IIKelantan, Malaysia; Sanglah Hospital, Udayana UniversityBali, Indonesia; TREAT Asia, amfAR-the Foundation for AIDS ResearchBangkok, Thailand
BACKGROUND: Combination antiretroviral therapy (cART) failure is a major threat to human immunodeficiency virus (HIV) programs, with implications for individual- and population-level outcomes. Adolescents with perinatally acquired HIV infection (PHIVA) should be a focus for treatment failure given their poorer outcomes compared to children and adults. METHODS: Data (2014-2018) from a regional cohort of Asian PHIVA who received at least 6 months of continuous cART were analyzed. Treatment failure was defined according to World Health Organization criteria. Descriptive analyses were used to report treatment failure and subsequent management and evaluate postfailure CD4 count and viral load trends. Kaplan-Meier survival analyses were used to compare the cumulative incidence of death and loss to follow-up (LTFU) by treatment failure status. RESULTS: A total 3196 PHIVA were included in the analysis with a median follow-up period of 3.0 years, of whom 230 (7.2%) had experienced 292 treatment failure events (161 virologic, 128 immunologic, 11 clinical) at a rate of 3.78 per 100 person-years. Of the 292 treatment failure events, 31 (10.6%) had a subsequent cART switch within 6 months, which resulted in better immunologic and virologic outcomes compared to those who did not switch cART. The 5-year cumulative incidence of death and LTFU following treatment failure was 18.5% compared to 10.1% without treatment failure. CONCLUSIONS: Improved implementation of virologic monitoring is required to realize the benefits of virologic determination of cART failure. There is a need to address issues related to accessibility to subsequent cART regimens, poor adherence limiting scope to switch regimens, and the role of antiretroviral resistance testing. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..
anti human immunodeficiency virus agent; adolescent; adult; Asia; CD4 lymphocyte count; child; female; human; Human immunodeficiency virus infection; pregnancy; treatment failure; virus load; Adolescent; Adult; Anti-HIV Agents; Asia; CD4 Lymphocyte Count; Child; Female; HIV Infections; Humans; Pregnancy; Treatment Failure; Viral Load
NLM (Medline)
15376591
32589711
Article
Q1
3440
518