Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program.

IF 2.2 Q3 INFECTIOUS DISEASES Journal of the International Association of Providers of AIDS Care Pub Date : 2023-01-01 DOI:10.1177/23259582231220513

Pupe Sudsila, Sirinya Teeraananchai, Sasisopin Kiertiburanakul, Cheewanan Lertpiriyasuwat, Rattaphon Triamwichanon, Sivaporn Gatechompol, Opass Putcharoen, Ploenchan Chetchotisakd, Anchalee Avihingsanon, Stephen J Kerr, Kiat Ruxrungtham

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Abstract

This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged ≥18 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load ≥1000 copies/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.

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转用二线抗逆转录病毒疗法后的治疗效果：泰国国家治疗计划的结果。

本研究旨在评估国家艾滋病治疗项目中二线抗逆转录病毒疗法（ART）的疗效。2008年1月至2019年5月期间，年龄≥18岁的艾滋病病毒感染者开始接受一线抗逆转录病毒疗法，并转为二线蛋白酶抑制剂治疗方案，随访至少1年。主要结果是二线治疗失败（连续两次病毒学失败（病毒载量≥1000拷贝/毫升））。在 318,506 名开始接受抗逆转录病毒疗法的 PLH 中，29,015 人（9.1%）在抗逆转录病毒疗法持续时间中位数（IQR）为 1.63（0.60-3.59）年后转为二线治疗方案。5316人（18.3%）失去随访机会，其中1376人（5%）仍未失去随访机会并存活；4606人（15.9%）死亡。二线治疗失败的累积发生率为 9.8%（6 年），女性、较年轻的 PLH 和 CD4 细胞计数较低的转换者更常见。需要建立多学科的创新支持系统，以改善二线治疗效果，尤其是与可改变的风险因素有关的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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