LOGIN

International Epidemiology Databases to Evaluate AIDS

Home >> Publications >> Efficacy of Second-Line Antiretroviral Therapy Among People Living With HIV/AIDS in Asia: Results From the TREAT Asia HIV Observational Database.

Publication

Author(s):

Boettiger DC, Nguyen VK, Durier N, Bui HV, Heng Sim BL, Azwa I, Law M, Ruxrungtham K.

Pub Title:

Efficacy of Second-Line Antiretroviral Therapy Among People Living With HIV/AIDS in Asia: Results From the TREAT Asia HIV Observational Database.

Pub Date:

Feb 1 2015

Pub Region(s):

Asia-Pacific

Journal:

Title: 
JAIDS- Journal of Acquired Immune Deficiency Syndromes
Link: 
http://ovidsp.tx.ovid.com/sp-3.14.0b/ovidweb.cgi?QS2=434f4e1a73d37e8c54b7bccef7797d0c15c6d8a694d4f75f4f19325f35d7e0aed3aefef5417e8569c47ce8bf1a9e6fce6a07cd9a09d306646b18f50d459b3dbacb6c3150a1e1123a9e2f0bfb0ce28fc090a60da68bba920ecd785f95fc998d4b90fc7c1041

PubMed: 25590271
Pub PDF: PDF icon 25590271.pdf

Abstract
BACKGROUND:
Roughly 4% of the 1.25 million patients on antiretroviral therapy (ART) in Asia are using second-line therapy. To maximize patient benefit and regional resources, it is important to optimize the timing of second-line ART initiation and use the most effective compounds available.

METHODS: HIV-positive patients enrolled in the TREAT Asia HIV Observational Database who had used second-line ART for ≥6 months were included. ART use and rates and predictors of second-line treatment failure were evaluated.

RESULTS: There were 302 eligible patients. Most were male (76.5%) and exposed to HIV via heterosexual contact (71.5%). Median age at second-line initiation was 39.2 years, median CD4 cell count was 146 cells per cubic millimeter, and median HIV viral load was 16,224 copies per milliliter. Patients started second-line ART before 2007 (n = 105), 2007-2010 (n = 147) and after 2010 (n = 50). Ritonavir-boosted lopinavir and atazanavir accounted for the majority of protease inhibitor use after 2006. Median follow-up time on second-line therapy was 2.3 years. The rates of treatment failure and mortality per 100 patient/years were 8.8 (95% confidence interval: 7.1 to 10.9) and 1.1 (95% confidence interval: 0.6 to 1.9), respectively. Older age, high baseline viral load, and use of a protease inhibitor other than lopinavir or atazanavir were associated with a significantly shorter time to second-line failure.

CONCLUSIONS: Increased access to viral load monitoring to facilitate early detection of first-line ART failure and subsequent treatment switch is important for maximizing the durability of second-line therapy in Asia. Although second-line ART is highly effective in the region, the reported rate of failure emphasizes the need for third-line ART in a small portion of patients.

The following websites provide guidelines and policies when citing from PubMed®: http://www.ncbi.nlm.nih.gov/books/NBK7243/
http://www.nlm.nih.gov/bsd/policy/cit_format.html

Citation:

Boettiger DC, Nguyen VK, Durier N, Bui HV, Heng Sim BL, Azwa I, Law M, Ruxrungtham K. Efficacy of Second-Line Antiretroviral Therapy Among People Living With HIV/AIDS in Asia: Results From the TREAT Asia HIV Observational Database. J Acquir Immune Defic Syndr. 2015 Feb 1;68(2):186-95. doi: 10.1097/QAI.0000000000000411. PubMed PMID: 25590271; PubMed Central PMCID: PMC4296907.