학술논문
Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV
Document Type
Report
Author
Sudjaritruk, Tavitiya; Boettiger, David C.; Van Nguyen, Lam; Mohamed, Thahira J.; Wati, Dewi K.; Bunupuradah, Torsak; Hansudewechakul, Rawiwan; Ly, Penh S.; Lumbiganon, Pagakrong; Nallusamy, Revathy A.; Fong, Moy S.; Chokephaibulkit, Kulkanya; Yusoff, Nik K Nik; Truong, Khanh H.; Do, Viet C.; Sohn, Annette H.; Sirisanthana, Virat; Tucker, J; Kumarasamy, N; Chandrasekaran, E; Vedaswari, D; Ramajaya, Ib; Kurniati, N; Muktiarti, D; Lim, M; Daut, F; Mohamad, P; Drawis, Mr; Chan, Kc; Aurpibul, L; Hansudewechakul, R; Ounchanum, P; Denjanta, S; Kongphonoi, A; Kosalaraksa, P; Tharnprisan, P; Udomphanit, T; Jourdain, G; Puthanakit, T; Anugulruengkit, S; Jantarabenjakul, W; Nadsasarn, R; Lapphra, K; Phongsamart, W; Sricharoenchai, S; Du, Qt; Nguyen, Ch; Ha, Tm; An, Vt; Khu, Dtk; Pham, An; Nguyen, Lt; Le, On; Chi, Ho; Ross, Jl; Suwanlerk, T; Law, Mg; Kariminia, A
Source
Journal of the International AIDS Society. June, 2019, Vol. 22 Issue 6
Subject
Language
English
ISSN
1758-2652
Abstract
: Introduction: Recommendations on the optimal frequency of plasma viral load (pVL) monitoring in children living with HIV (CLWH) who are stable on combination antiretroviral therapy (cART) are inconsistent. This study aimed to determine the impact of annual versus semi‐annual pVL monitoring on treatment outcomes in Asian CLWH. Methods: Data on children with perinatally acquired HIV aged 1.5 tests/patient/year. Treatment failure was defined as virologic failure (two consecutive pVL >1000 copies/mL), change of antiretroviral drug class, or death. Baseline was the date of the second consecutive pVL Results: During January 2008 to March 2015, there were 1220 eligible children from 10 sites that performed at least annual pVL monitoring, 1042 (85%) and 178 (15%) were from sites performing annual (n = 6) and semi‐annual pVL monitoring (n = 4) respectively. Pre‐cART, 675 children (55%) had World Health Organization clinical stage 3 or 4, the median nadir CD4 percentage was 9%, and the median pVL was 5.2 log[sub.10] copies/mL. At baseline, the median age was 9.2 years, 64% were on nevirapine‐based regimens, the median cART duration was 1.6 years, and the median CD4 percentage was 26%. Over the follow‐up period, 258 (25%) CLWH with annual and 40 (23%) with semi‐annual pVL monitoring developed treatment failure, corresponding to incidence rates of 5.4 (95% CI: 4.8 to 6.1) and 4.3 (95% CI: 3.1 to 5.8) per 100 patient‐years of follow‐up respectively (p = 0.27). In multivariable analyses, the frequency of pVL monitoring was not associated with treatment failure (adjusted hazard ratio: 1.12; 95% CI: 0.80 to 1.59). Conclusions: Annual compared to semi‐annual pVL monitoring was not associated with an increased risk of treatment failure in our cohort of virally suppressed children with perinatally acquired HIV on first‐line NNRTI‐based cART.
Abbreviations Introduction In 2017, there were an estimated 1.8 million children younger than 15 years of age living with HIV (CLWH) worldwide, of whom 110,000 were in the Asia‐Pacific region. [...]
Abbreviations Introduction In 2017, there were an estimated 1.8 million children younger than 15 years of age living with HIV (CLWH) worldwide, of whom 110,000 were in the Asia‐Pacific region. [...]