Patterns and prognosis of holding regimens for people living with HIV in Asian countries
The use of holding regimens for people living with HIV (PLWH) without effective antiretroviral options can have effects on outcomes and future treatment options. We aimed to investigate the use of holding regimens for PLWH in Asian countries. Data from adults enrolled in routine HIV care in IeDEA As...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967045/ https://www.ncbi.nlm.nih.gov/pubmed/35353840 http://dx.doi.org/10.1371/journal.pone.0264157 |
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author | Kim, Jung Ho Jiamsakul, Awachana Kiertiburanakul, Sasisopin Huy, Bui Vu Khusuwan, Suwimon Kumarasamy, Nagalingeswaran Ng, Oon Tek Ly, Penh Sun Lee, Man-Po Chan, Yu-Jiun Gani, Yasmin Mohamed Azwa, Iskandar Avihingsanon, Anchalee Merati, Tuti Parwati Pujari, Sanjay Chaiwarith, Romanee Zhang, Fujie Tanuma, Junko Do, Cuong Duy Ditangco, Rossana Yunihastuti, Evy Ross, Jeremy Choi, Jun Yong |
author_facet | Kim, Jung Ho Jiamsakul, Awachana Kiertiburanakul, Sasisopin Huy, Bui Vu Khusuwan, Suwimon Kumarasamy, Nagalingeswaran Ng, Oon Tek Ly, Penh Sun Lee, Man-Po Chan, Yu-Jiun Gani, Yasmin Mohamed Azwa, Iskandar Avihingsanon, Anchalee Merati, Tuti Parwati Pujari, Sanjay Chaiwarith, Romanee Zhang, Fujie Tanuma, Junko Do, Cuong Duy Ditangco, Rossana Yunihastuti, Evy Ross, Jeremy Choi, Jun Yong |
author_sort | Kim, Jung Ho |
collection | PubMed |
description | The use of holding regimens for people living with HIV (PLWH) without effective antiretroviral options can have effects on outcomes and future treatment options. We aimed to investigate the use of holding regimens for PLWH in Asian countries. Data from adults enrolled in routine HIV care in IeDEA Asia-Pacific cohorts were included. Individuals were considered to be on holding regimen if they had been on combination antiretroviral therapy for at least 6 months, had two confirmed viral loads (VL) ≥1000 copies/mL, and had remained on the same medications for at least 6 months. Survival time was analyzed using Fine and Gray’s competing risk regression. Factors associated with CD4 changes and VL <1000 copies/mL were analyzed using linear regression and logistic regression, respectively. A total of 425 PLWH (72.9% male; 45.2% high-income and 54.8% low-to-middle-income country) met criteria for being on a holding regimen. From high-income countries, 63.0% were on protease inhibitors (PIs); from low-to-middle-income countries, 58.4% were on non-nucleoside reverse transcriptase inhibitors (NNRTIs); overall, 4.5% were on integrase inhibitors. The combination of lamivudine, zidovudine, and efavirenz was the most commonly used single regimen (n = 46, 10.8%), followed by lamivudine, zidovudine, and nevirapine (n = 37, 8.7%). Forty-one PLWH (9.7%) died during follow-up (mortality rate 2.0 per 100 person-years). Age >50 years compared to age 31–40 years (sub-hazard ratio [SHR] 3.29, 95% CI 1.45–7.43, p = 0.004), and VL ≥1000 copies/ml compared to VL <1000 copies/mL (SHR, 2.14, 95% CI 1.08–4.25, p = 0.029) were associated with increased mortality, while higher CD4 counts were protective. In our Asia regional cohort, there was a diversity of holding regimens, and the patterns of PI vs. NNRTI use differed by country income levels. Considering the high mortality rate of PLWH with holding regimen, efforts to extend accessibility to additional antiretroviral options are needed in our region. |
format | Online Article Text |
id | pubmed-8967045 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-89670452022-03-31 Patterns and prognosis of holding regimens for people living with HIV in Asian countries Kim, Jung Ho Jiamsakul, Awachana Kiertiburanakul, Sasisopin Huy, Bui Vu Khusuwan, Suwimon Kumarasamy, Nagalingeswaran Ng, Oon Tek Ly, Penh Sun Lee, Man-Po Chan, Yu-Jiun Gani, Yasmin Mohamed Azwa, Iskandar Avihingsanon, Anchalee Merati, Tuti Parwati Pujari, Sanjay Chaiwarith, Romanee Zhang, Fujie Tanuma, Junko Do, Cuong Duy Ditangco, Rossana Yunihastuti, Evy Ross, Jeremy Choi, Jun Yong PLoS One Research Article The use of holding regimens for people living with HIV (PLWH) without effective antiretroviral options can have effects on outcomes and future treatment options. We aimed to investigate the use of holding regimens for PLWH in Asian countries. Data from adults enrolled in routine HIV care in IeDEA Asia-Pacific cohorts were included. Individuals were considered to be on holding regimen if they had been on combination antiretroviral therapy for at least 6 months, had two confirmed viral loads (VL) ≥1000 copies/mL, and had remained on the same medications for at least 6 months. Survival time was analyzed using Fine and Gray’s competing risk regression. Factors associated with CD4 changes and VL <1000 copies/mL were analyzed using linear regression and logistic regression, respectively. A total of 425 PLWH (72.9% male; 45.2% high-income and 54.8% low-to-middle-income country) met criteria for being on a holding regimen. From high-income countries, 63.0% were on protease inhibitors (PIs); from low-to-middle-income countries, 58.4% were on non-nucleoside reverse transcriptase inhibitors (NNRTIs); overall, 4.5% were on integrase inhibitors. The combination of lamivudine, zidovudine, and efavirenz was the most commonly used single regimen (n = 46, 10.8%), followed by lamivudine, zidovudine, and nevirapine (n = 37, 8.7%). Forty-one PLWH (9.7%) died during follow-up (mortality rate 2.0 per 100 person-years). Age >50 years compared to age 31–40 years (sub-hazard ratio [SHR] 3.29, 95% CI 1.45–7.43, p = 0.004), and VL ≥1000 copies/ml compared to VL <1000 copies/mL (SHR, 2.14, 95% CI 1.08–4.25, p = 0.029) were associated with increased mortality, while higher CD4 counts were protective. In our Asia regional cohort, there was a diversity of holding regimens, and the patterns of PI vs. NNRTI use differed by country income levels. Considering the high mortality rate of PLWH with holding regimen, efforts to extend accessibility to additional antiretroviral options are needed in our region. Public Library of Science 2022-03-30 /pmc/articles/PMC8967045/ /pubmed/35353840 http://dx.doi.org/10.1371/journal.pone.0264157 Text en © 2022 Kim et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kim, Jung Ho Jiamsakul, Awachana Kiertiburanakul, Sasisopin Huy, Bui Vu Khusuwan, Suwimon Kumarasamy, Nagalingeswaran Ng, Oon Tek Ly, Penh Sun Lee, Man-Po Chan, Yu-Jiun Gani, Yasmin Mohamed Azwa, Iskandar Avihingsanon, Anchalee Merati, Tuti Parwati Pujari, Sanjay Chaiwarith, Romanee Zhang, Fujie Tanuma, Junko Do, Cuong Duy Ditangco, Rossana Yunihastuti, Evy Ross, Jeremy Choi, Jun Yong Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title | Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title_full | Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title_fullStr | Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title_full_unstemmed | Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title_short | Patterns and prognosis of holding regimens for people living with HIV in Asian countries |
title_sort | patterns and prognosis of holding regimens for people living with hiv in asian countries |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967045/ https://www.ncbi.nlm.nih.gov/pubmed/35353840 http://dx.doi.org/10.1371/journal.pone.0264157 |
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