The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):

In Young Jung; David Boettiger; Wing Wai Wong; Man Po Lee; Sasisopin Kiertiburanakul; Romanee Chaiwarith; Anchalee Avihingsanon; Junko Tanuma; Nagalingeswaran Kumarasamy; Adeeba Kamarulzaman; Fujie Zhang; Pacharee Kantipong; Oon Tek Ng; Benedict Lim Heng Sim; Matthew Law; Jeremy Ross; Jun Yong Choi

doi:10.1002/jia2.25016

The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):

In Young Jung, David Boettiger, Wing Wai Wong, Man Po Lee, Sasisopin Kiertiburanakul, Romanee Chaiwarith, Anchalee Avihingsanon, Junko Tanuma, Nagalingeswaran Kumarasamy, Adeeba Kamarulzaman, Fujie Zhang, Pacharee Kantipong, Oon Tek Ng, Benedict Lim Heng Sim, Matthew Law, Jeremy Ross, Jun Yong Choi

Department of Internal Medicine

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

2 Citations (Scopus)

Abstract

Introduction: Although substitutions of antiretroviral regimen are generally safe, most data on substitutions are based on results from clinical trials. The objective of this study was to evaluate the treatment outcomes of substituting antiretroviral regimen in virologically suppressed HIV-infected patients in non-clinical trial settings in Asian countries. Methods: The study population consisted of HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD). Individuals were included in this analysis if they started combination antiretroviral treatment (cART) after 2002, were being treated at a centre that documented a median rate of viral load monitoring ≥0.8 tests/patient/year among TAHOD enrolees, and experienced a minor or major treatment substitution while on virally suppressive cART. The primary endpoint to evaluate outcomes was clinical or virological failure (VF), followed by an ART class change. Clinical failure was defined as death or an AIDS diagnosis. VF was defined as confirmed viral load measurements ≥400 copies/mL followed by an ART class change within six months. Minor regimen substitutions were defined as within-class changes and major regimen substitutions were defined as changes to a drug class. The patterns of substitutions and rate of clinical or VF after substitutions were analyzed. Results: Of 3994 adults who started ART after 2002, 3119 (78.1%) had at least one period of virological suppression. Among these, 1170 (37.5%) underwent a minor regimen substitution, and 296 (9.5%) underwent a major regimen substitution during suppression. The rates of clinical or VF were 1.48/100 person years (95% CI 1.14 to 1.91) in the minor substitution group, 2.85/100 person years (95% CI 1.88 to 4.33) in the major substitution group and 2.53/100 person years (95% CI 2.20 to 2.92) among patients that did not undergo a treatment substitution. Conclusions: The rate of clinical or VF was low in both major and minor substitution groups, showing that regimen substitution is generally effective in non-clinical trial settings in Asian countries.

Original language	English
Article number	e25016
Journal	Journal of the International AIDS Society
Volume	20
Issue number	4
DOIs	https://doi.org/10.1002/jia2.25016
Publication status	Published - 2017 Dec

Bibliographical note

Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. 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. JYC’s involvement was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2005412), a Chronic Infectious Disease Cohort grant (4800-4859-304-260) from the Korea Centers for Disease Control and Prevention, BioNano Health-Guard Research Center funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD_2013M3A6B2078953), a faculty research grant of Yonsei University College of Medicine for (6-2015-0153) and a grant from the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1324). 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.

Publisher Copyright:
© 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

All Science Journal Classification (ASJC) codes

Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1002/jia2.25016

Cite this

Jung, I. Y., Boettiger, D., Wong, W. W., Lee, M. P., Kiertiburanakul, S., Chaiwarith, R., Avihingsanon, A., Tanuma, J., Kumarasamy, N., Kamarulzaman, A., Zhang, F., Kantipong, P., Ng, O. T., Sim, B. L. H., Law, M., Ross, J., & Choi, J. Y. (2017). The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD): Journal of the International AIDS Society, 20(4), [e25016]. https://doi.org/10.1002/jia2.25016

@article{b757e68d7f634517bfff4797a50b9ff6,

title = "The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):",

abstract = "Introduction: Although substitutions of antiretroviral regimen are generally safe, most data on substitutions are based on results from clinical trials. The objective of this study was to evaluate the treatment outcomes of substituting antiretroviral regimen in virologically suppressed HIV-infected patients in non-clinical trial settings in Asian countries. Methods: The study population consisted of HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD). Individuals were included in this analysis if they started combination antiretroviral treatment (cART) after 2002, were being treated at a centre that documented a median rate of viral load monitoring ≥0.8 tests/patient/year among TAHOD enrolees, and experienced a minor or major treatment substitution while on virally suppressive cART. The primary endpoint to evaluate outcomes was clinical or virological failure (VF), followed by an ART class change. Clinical failure was defined as death or an AIDS diagnosis. VF was defined as confirmed viral load measurements ≥400 copies/mL followed by an ART class change within six months. Minor regimen substitutions were defined as within-class changes and major regimen substitutions were defined as changes to a drug class. The patterns of substitutions and rate of clinical or VF after substitutions were analyzed. Results: Of 3994 adults who started ART after 2002, 3119 (78.1%) had at least one period of virological suppression. Among these, 1170 (37.5%) underwent a minor regimen substitution, and 296 (9.5%) underwent a major regimen substitution during suppression. The rates of clinical or VF were 1.48/100 person years (95% CI 1.14 to 1.91) in the minor substitution group, 2.85/100 person years (95% CI 1.88 to 4.33) in the major substitution group and 2.53/100 person years (95% CI 2.20 to 2.92) among patients that did not undergo a treatment substitution. Conclusions: The rate of clinical or VF was low in both major and minor substitution groups, showing that regimen substitution is generally effective in non-clinical trial settings in Asian countries.",

author = "Jung, {In Young} and David Boettiger and Wong, {Wing Wai} and Lee, {Man Po} and Sasisopin Kiertiburanakul and Romanee Chaiwarith and Anchalee Avihingsanon and Junko Tanuma and Nagalingeswaran Kumarasamy and Adeeba Kamarulzaman and Fujie Zhang and Pacharee Kantipong and Ng, {Oon Tek} and Sim, {Benedict Lim Heng} and Matthew Law and Jeremy Ross and Choi, {Jun Yong}",

note = "Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. 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. JYC{\textquoteright}s involvement was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2005412), a Chronic Infectious Disease Cohort grant (4800-4859-304-260) from the Korea Centers for Disease Control and Prevention, BioNano Health-Guard Research Center funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD_2013M3A6B2078953), a faculty research grant of Yonsei University College of Medicine for (6-2015-0153) and a grant from the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1324). 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. Publisher Copyright: {\textcopyright} 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.",

year = "2017",

month = dec,

doi = "10.1002/jia2.25016",

language = "English",

volume = "20",

journal = "Journal of the International AIDS Society",

issn = "1758-2652",

publisher = "International AIDS Society",

number = "4",

}

Jung, IY, Boettiger, D, Wong, WW, Lee, MP, Kiertiburanakul, S, Chaiwarith, R, Avihingsanon, A, Tanuma, J, Kumarasamy, N, Kamarulzaman, A, Zhang, F, Kantipong, P, Ng, OT, Sim, BLH, Law, M, Ross, J & Choi, JY 2017, 'The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):', Journal of the International AIDS Society, vol. 20, no. 4, e25016. https://doi.org/10.1002/jia2.25016

TY - JOUR

T1 - The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):

AU - Jung, In Young

AU - Boettiger, David

AU - Wong, Wing Wai

AU - Lee, Man Po

AU - Kiertiburanakul, Sasisopin

AU - Chaiwarith, Romanee

AU - Avihingsanon, Anchalee

AU - Tanuma, Junko

AU - Kumarasamy, Nagalingeswaran

AU - Kamarulzaman, Adeeba

AU - Zhang, Fujie

AU - Kantipong, Pacharee

AU - Ng, Oon Tek

AU - Sim, Benedict Lim Heng

AU - Law, Matthew

AU - Ross, Jeremy

AU - Choi, Jun Yong

N1 - Funding Information: The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the U.S. 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. JYC’s involvement was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2005412), a Chronic Infectious Disease Cohort grant (4800-4859-304-260) from the Korea Centers for Disease Control and Prevention, BioNano Health-Guard Research Center funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD_2013M3A6B2078953), a faculty research grant of Yonsei University College of Medicine for (6-2015-0153) and a grant from the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1324). 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. Publisher Copyright: © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

PY - 2017/12

Y1 - 2017/12

N2 - Introduction: Although substitutions of antiretroviral regimen are generally safe, most data on substitutions are based on results from clinical trials. The objective of this study was to evaluate the treatment outcomes of substituting antiretroviral regimen in virologically suppressed HIV-infected patients in non-clinical trial settings in Asian countries. Methods: The study population consisted of HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD). Individuals were included in this analysis if they started combination antiretroviral treatment (cART) after 2002, were being treated at a centre that documented a median rate of viral load monitoring ≥0.8 tests/patient/year among TAHOD enrolees, and experienced a minor or major treatment substitution while on virally suppressive cART. The primary endpoint to evaluate outcomes was clinical or virological failure (VF), followed by an ART class change. Clinical failure was defined as death or an AIDS diagnosis. VF was defined as confirmed viral load measurements ≥400 copies/mL followed by an ART class change within six months. Minor regimen substitutions were defined as within-class changes and major regimen substitutions were defined as changes to a drug class. The patterns of substitutions and rate of clinical or VF after substitutions were analyzed. Results: Of 3994 adults who started ART after 2002, 3119 (78.1%) had at least one period of virological suppression. Among these, 1170 (37.5%) underwent a minor regimen substitution, and 296 (9.5%) underwent a major regimen substitution during suppression. The rates of clinical or VF were 1.48/100 person years (95% CI 1.14 to 1.91) in the minor substitution group, 2.85/100 person years (95% CI 1.88 to 4.33) in the major substitution group and 2.53/100 person years (95% CI 2.20 to 2.92) among patients that did not undergo a treatment substitution. Conclusions: The rate of clinical or VF was low in both major and minor substitution groups, showing that regimen substitution is generally effective in non-clinical trial settings in Asian countries.

AB - Introduction: Although substitutions of antiretroviral regimen are generally safe, most data on substitutions are based on results from clinical trials. The objective of this study was to evaluate the treatment outcomes of substituting antiretroviral regimen in virologically suppressed HIV-infected patients in non-clinical trial settings in Asian countries. Methods: The study population consisted of HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD). Individuals were included in this analysis if they started combination antiretroviral treatment (cART) after 2002, were being treated at a centre that documented a median rate of viral load monitoring ≥0.8 tests/patient/year among TAHOD enrolees, and experienced a minor or major treatment substitution while on virally suppressive cART. The primary endpoint to evaluate outcomes was clinical or virological failure (VF), followed by an ART class change. Clinical failure was defined as death or an AIDS diagnosis. VF was defined as confirmed viral load measurements ≥400 copies/mL followed by an ART class change within six months. Minor regimen substitutions were defined as within-class changes and major regimen substitutions were defined as changes to a drug class. The patterns of substitutions and rate of clinical or VF after substitutions were analyzed. Results: Of 3994 adults who started ART after 2002, 3119 (78.1%) had at least one period of virological suppression. Among these, 1170 (37.5%) underwent a minor regimen substitution, and 296 (9.5%) underwent a major regimen substitution during suppression. The rates of clinical or VF were 1.48/100 person years (95% CI 1.14 to 1.91) in the minor substitution group, 2.85/100 person years (95% CI 1.88 to 4.33) in the major substitution group and 2.53/100 person years (95% CI 2.20 to 2.92) among patients that did not undergo a treatment substitution. Conclusions: The rate of clinical or VF was low in both major and minor substitution groups, showing that regimen substitution is generally effective in non-clinical trial settings in Asian countries.

UR - http://www.scopus.com/inward/record.url?scp=85039734273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039734273&partnerID=8YFLogxK

U2 - 10.1002/jia2.25016

DO - 10.1002/jia2.25016

M3 - Article

C2 - 29243388

AN - SCOPUS:85039734273

SN - 1758-2652

VL - 20

JO - Journal of the International AIDS Society

JF - Journal of the International AIDS Society

IS - 4

M1 - e25016

ER -

The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; Data from the TREAT Asia HIV Observational Database (TAHOD):

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this