Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)

Rosario Martinez-Vega; Nicole L.De La Mata; Nagalingeswaran Kumarasamy; Penh Sun Ly; Kinh Van Nguyen; Tuti P. Merati; Thi Thanh Pham; Man Po Lee; Jun Yong Choi; Jeremy L. Ross; Oon Tek Ng

doi:10.3851/IMP3194

Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)

Rosario Martinez-Vega, Nicole L.De La Mata, Nagalingeswaran Kumarasamy, Penh Sun Ly, Kinh Van Nguyen, Tuti P. Merati, Thi Thanh Pham, Man Po Lee, Jun Yong Choi, Jeremy L. Ross, Oon Tek Ng

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background: The durability of first-line regimen is important to achieve long-term treatment success for the management of HIV infection. Our analysis describes the duration of sequential ART regimens and identifies the determinants leading to treatment change in HIV-positive patients initiating in Asia. Methods: All HIV-positive adult patients initiating first-line ART in 2003–2013, from eight clinical sites among seven countries in Asia. Patient follow-up was to May 2014. Kaplan–Meier curves were used to estimate the time to second-line ART and third-line ART regimen. Factors associated with treatment durability were assessed using Cox proportional hazards model. Results: A total of 16,962 patients initiated first-line ART. Of these, 4,336 patients initiated second-line ART over 38,798 person-years (pys), a crude rate of 11.2 (95% CI 10.8, 11.5) per 100 pys. The probability of being on first-line ART increased from 83.7% (95% CI 82.1, 85.1%) in 2003–2005 to 87.9% (95% CI 87.1, 88.6%) in 2010–2013. Third-line ART was initiated by 1,135 patients over 8,078 pys, a crude rate of 14.0 (95% CI 13.3, 14.9) per 100 pys. The probability of continuing second-line ART significantly increased from 64.9% (95% CI 58.5, 70.6%) in 2003–2005 to 86.2% (95% CI 84.7, 87.6%) in 2010–2013. Conclusions: Rates of discontinuation of first- and second-line regimens have decreased over the last decade in Asia. Subsequent regimens were of shorter duration compared to the first-line regimen initiated in the same year period. Lower CD4⁺ T-cell count and the use of suboptimal regimens were important factors associated with higher risk of treatment switch.

Original language	English
Pages (from-to)	167-178
Number of pages	12
Journal	Antiviral therapy
Volume	23
Issue number	2
DOIs	https://doi.org/10.3851/IMP3194
Publication status	Published - 2018

Bibliographical note

Funding Information:
A list of the TAHOD-LITE study members can be found in Additional file 4. The TREAT Asia HIV Observational Database Low-Intensity TransfEr study is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. RM-V and OTN contributed to the concept development. NK, PSL, KVN, TPM, TTP, MPL, JYC and OTN contributed data for the analysis. NLDLM performed the statistical analysis and wrote the methods and results section. RM-V wrote the remainder of the manuscript for the first draft. All authors commented on the draft manuscript and approved of the final manuscript for submission.

Publisher Copyright:
© 2018 International Medical Press.

All Science Journal Classification (ASJC) codes

Pharmacology
Pharmacology (medical)
Infectious Diseases

UN SDGs

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Martinez-Vega, R., La Mata, N. L. D., Kumarasamy, N., Ly, P. S., Van Nguyen, K., Merati, T. P., Pham, T. T., Lee, M. P., Choi, J. Y., Ross, J. L., & Ng, O. T. (2018). Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE). Antiviral therapy, 23(2), 167-178. https://doi.org/10.3851/IMP3194

@article{dd03acf20b944037befb55ba0cb10724,

title = "Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)",

abstract = "Background: The durability of first-line regimen is important to achieve long-term treatment success for the management of HIV infection. Our analysis describes the duration of sequential ART regimens and identifies the determinants leading to treatment change in HIV-positive patients initiating in Asia. Methods: All HIV-positive adult patients initiating first-line ART in 2003–2013, from eight clinical sites among seven countries in Asia. Patient follow-up was to May 2014. Kaplan–Meier curves were used to estimate the time to second-line ART and third-line ART regimen. Factors associated with treatment durability were assessed using Cox proportional hazards model. Results: A total of 16,962 patients initiated first-line ART. Of these, 4,336 patients initiated second-line ART over 38,798 person-years (pys), a crude rate of 11.2 (95% CI 10.8, 11.5) per 100 pys. The probability of being on first-line ART increased from 83.7% (95% CI 82.1, 85.1%) in 2003–2005 to 87.9% (95% CI 87.1, 88.6%) in 2010–2013. Third-line ART was initiated by 1,135 patients over 8,078 pys, a crude rate of 14.0 (95% CI 13.3, 14.9) per 100 pys. The probability of continuing second-line ART significantly increased from 64.9% (95% CI 58.5, 70.6%) in 2003–2005 to 86.2% (95% CI 84.7, 87.6%) in 2010–2013. Conclusions: Rates of discontinuation of first- and second-line regimens have decreased over the last decade in Asia. Subsequent regimens were of shorter duration compared to the first-line regimen initiated in the same year period. Lower CD4+ T-cell count and the use of suboptimal regimens were important factors associated with higher risk of treatment switch.",

author = "Rosario Martinez-Vega and {La Mata}, {Nicole L.De} and Nagalingeswaran Kumarasamy and Ly, {Penh Sun} and {Van Nguyen}, Kinh and Merati, {Tuti P.} and Pham, {Thi Thanh} and Lee, {Man Po} and Choi, {Jun Yong} and Ross, {Jeremy L.} and Ng, {Oon Tek}",

note = "Funding Information: A list of the TAHOD-LITE study members can be found in Additional file 4. The TREAT Asia HIV Observational Database Low-Intensity TransfEr study is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. RM-V and OTN contributed to the concept development. NK, PSL, KVN, TPM, TTP, MPL, JYC and OTN contributed data for the analysis. NLDLM performed the statistical analysis and wrote the methods and results section. RM-V wrote the remainder of the manuscript for the first draft. All authors commented on the draft manuscript and approved of the final manuscript for submission. Publisher Copyright: {\textcopyright} 2018 International Medical Press.",

year = "2018",

doi = "10.3851/IMP3194",

language = "English",

volume = "23",

pages = "167--178",

journal = "Antiviral Therapy",

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Martinez-Vega, R, La Mata, NLD, Kumarasamy, N, Ly, PS, Van Nguyen, K, Merati, TP, Pham, TT, Lee, MP, Choi, JY, Ross, JL & Ng, OT 2018, 'Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)', Antiviral therapy, vol. 23, no. 2, pp. 167-178. https://doi.org/10.3851/IMP3194

TY - JOUR

T1 - Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)

AU - Martinez-Vega, Rosario

AU - La Mata, Nicole L.De

AU - Kumarasamy, Nagalingeswaran

AU - Ly, Penh Sun

AU - Van Nguyen, Kinh

AU - Merati, Tuti P.

AU - Pham, Thi Thanh

AU - Lee, Man Po

AU - Choi, Jun Yong

AU - Ross, Jeremy L.

AU - Ng, Oon Tek

N1 - Funding Information: A list of the TAHOD-LITE study members can be found in Additional file 4. The TREAT Asia HIV Observational Database Low-Intensity TransfEr study is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, and the National Institute on Drug Abuse, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above. RM-V and OTN contributed to the concept development. NK, PSL, KVN, TPM, TTP, MPL, JYC and OTN contributed data for the analysis. NLDLM performed the statistical analysis and wrote the methods and results section. RM-V wrote the remainder of the manuscript for the first draft. All authors commented on the draft manuscript and approved of the final manuscript for submission. Publisher Copyright: © 2018 International Medical Press.

PY - 2018

Y1 - 2018

N2 - Background: The durability of first-line regimen is important to achieve long-term treatment success for the management of HIV infection. Our analysis describes the duration of sequential ART regimens and identifies the determinants leading to treatment change in HIV-positive patients initiating in Asia. Methods: All HIV-positive adult patients initiating first-line ART in 2003–2013, from eight clinical sites among seven countries in Asia. Patient follow-up was to May 2014. Kaplan–Meier curves were used to estimate the time to second-line ART and third-line ART regimen. Factors associated with treatment durability were assessed using Cox proportional hazards model. Results: A total of 16,962 patients initiated first-line ART. Of these, 4,336 patients initiated second-line ART over 38,798 person-years (pys), a crude rate of 11.2 (95% CI 10.8, 11.5) per 100 pys. The probability of being on first-line ART increased from 83.7% (95% CI 82.1, 85.1%) in 2003–2005 to 87.9% (95% CI 87.1, 88.6%) in 2010–2013. Third-line ART was initiated by 1,135 patients over 8,078 pys, a crude rate of 14.0 (95% CI 13.3, 14.9) per 100 pys. The probability of continuing second-line ART significantly increased from 64.9% (95% CI 58.5, 70.6%) in 2003–2005 to 86.2% (95% CI 84.7, 87.6%) in 2010–2013. Conclusions: Rates of discontinuation of first- and second-line regimens have decreased over the last decade in Asia. Subsequent regimens were of shorter duration compared to the first-line regimen initiated in the same year period. Lower CD4+ T-cell count and the use of suboptimal regimens were important factors associated with higher risk of treatment switch.

AB - Background: The durability of first-line regimen is important to achieve long-term treatment success for the management of HIV infection. Our analysis describes the duration of sequential ART regimens and identifies the determinants leading to treatment change in HIV-positive patients initiating in Asia. Methods: All HIV-positive adult patients initiating first-line ART in 2003–2013, from eight clinical sites among seven countries in Asia. Patient follow-up was to May 2014. Kaplan–Meier curves were used to estimate the time to second-line ART and third-line ART regimen. Factors associated with treatment durability were assessed using Cox proportional hazards model. Results: A total of 16,962 patients initiated first-line ART. Of these, 4,336 patients initiated second-line ART over 38,798 person-years (pys), a crude rate of 11.2 (95% CI 10.8, 11.5) per 100 pys. The probability of being on first-line ART increased from 83.7% (95% CI 82.1, 85.1%) in 2003–2005 to 87.9% (95% CI 87.1, 88.6%) in 2010–2013. Third-line ART was initiated by 1,135 patients over 8,078 pys, a crude rate of 14.0 (95% CI 13.3, 14.9) per 100 pys. The probability of continuing second-line ART significantly increased from 64.9% (95% CI 58.5, 70.6%) in 2003–2005 to 86.2% (95% CI 84.7, 87.6%) in 2010–2013. Conclusions: Rates of discontinuation of first- and second-line regimens have decreased over the last decade in Asia. Subsequent regimens were of shorter duration compared to the first-line regimen initiated in the same year period. Lower CD4+ T-cell count and the use of suboptimal regimens were important factors associated with higher risk of treatment switch.

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Durability of antiretroviral therapy regimens and determinants for change in HIV-1-infected patients in the TREAT Asia HIV Observational Database (TAHOD-LITE)

Abstract

Bibliographical note

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UN SDGs

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