Journal of the Medical Association of Thailand = Chotmaihet thangphaet最新文献

{"title":"PCSK9 Levels Are Increased in Type 2 Diabetes Mellitus with, and without Statin Therapy in Thai Subjects","authors":"","doi":"10.35755/jmedassocthai.2023.03.13803","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13803","url":null,"abstract":"Background: Plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels were found associated with not only lipid profiles, but also glucose homeostasis. Nevertheless, the relationship between PCSK9 levels, and diabetes was inconsistent in various studies.\u0000\u0000Objective: To investigate the plasma PCSK9 levels among normoglycemia, pre-diabetes, and T2DM patients with, and without statin therapy in Thais.\u0000\u0000Materials and Methods: Five hundred fifty-three subjects including 213 normoglycemia, 176 pre-diabetes, 46 T2DM without statin therapy, 40 T2DM with simvastatin therapy at 20 mg/day, and 78 T2DM with simvastatin therapy at 40 mg/day were recruited. Anthropometric data, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), and PCSK9 levels were measured.\u0000\u0000Results: PCSK9 levels were significantly higher in T2DM without statin therapy compared with normoglycemic subjects. In addition, T2DM with simvastatin therapy (40 mg/day) had significantly higher PCSK9 levels than T2DM without statin therapy, and T2DM with simvastatin therapy (20 mg/day). Serum PCSK9 levels were positively correlated with several metabolic parameters including age, body mass index (BMI), systolic blood pressure (SBP), TC, TG, and FBS (p<0.05) in the present study subjects.\u0000\u0000Conclusion: PCSK9 levels were modulated by glycemic status, and statin therapy in Thai subjects. Elevation of plasma PCSK9 levels in T2DM with, and without statin therapy may increase the risk for dyslipidemia, and cardiovascular disease among T2DM patients.\u0000\u0000Keywords: PCSK9, Pre-diabetes, T2DM, FBS, Statin","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80940100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Manifestations, Pathological Correlations, Prognostic Factors, and Outcomes of Severe Acute Postinfectious Glomerulonephritis with Rapidly Progressive Glomerulonephritis in Children","authors":"","doi":"10.35755/jmedassocthai.2023.03.13805","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.03.13805","url":null,"abstract":"Objective: To describe clinical spectrum, as well as biochemical and histological factors that could predict severe presentations and renal outcomes among children with rapidly progressive glomerulonephritis (RPGN) due to postinfectious glomerulonephritis (PIGN).\u0000\u0000Material and Methods: A retrospective cohort study was conducted at Chiang Mai University Hospital, Thailand between February 2008 and January 2018. Ninety-six pediatric patients with PIGN were recruited. Clinical presentations, disease courses, laboratory data, renal histopathology, treatment, and outcomes were analyzed. Compare clinical manifestation and outcome between the two groups.\u0000\u0000Results: The median age (interquartile range, IQR) was 11 (8 to 13) years with a male-to-female ratio of 1.8:1. RPGN was identified in 51.04% (49/96 patients). PIGN children with RPGN exhibited a higher prevalence of nephrotic range proteinuria (69.4% versus 53.2%, p=0.04), nephrotic syndrome (46.9% versus 17%, p=0.002), and hypoalbuminemia (81.3% versus 53.8%, p<0.0001) compared with those without RPGN. Multivariate analysis revealed that anuria, and hypoalbuminemia were predicting factors of RPGN [odd ratios 0.07 (95% CI 0.01 to 0.77), p=0.03 and 0.23 (95% CI 0.08 to 0.69), p=0.006, respectively]. Follow-up data were available among 78 patients (81.3%) with a median follow-up time of 762 (256.3 to 1,293) days. Complete remission was identified in all of PIGN without RPGN but only 71.4% in the RPGN group. Kaplan-Meier analysis revealed that patients with RPGN had a longer recovery time of generalized edema at 14 days (95% CI 12 to 15.9) versus 9 days (95% CI 7 to 12), p=0.023; proteinuria at 16 weeks (95% CI 11 to 20.8) versus 8 weeks (95% CI 4.25 to 15.75), p<0.0001; and impaired glomerular filtration rate (GFR) of nine weeks (95% CI 4.8 to 13.2) versus two weeks (95% CI 1 to 8), p=0.003. Subgroup analysis of prognostic factors of PIGN with RPGN revealed that high BMI z-score and kidney replacement therapy (KRT) requirement were associated with poor renal outcomes.\u0000\u0000Conclusion: Hypoalbuminemia and anuria were predictive factors of RPGN in PIGN. High BMI z-score and low GFR required acute KRT were predictive factors of poor renal outcomes.\u0000\u0000Keywords: Postinfectious glomerulonephritis; Acute post streptococcal glomerulonephritis; Rapidly progressive glomerulonephritis; Children","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89894850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Signaling Pathway and Anti-Cancer Mechanism of Cannabidiol","authors":"","doi":"10.35755/jmedassocthai.2023.02.13749","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13749","url":null,"abstract":"Cannabidiol (CBD) is one of the major ingredients found in Cannabis. It has become of medical value due to containing various pharmacological properties such as analgesic, anti-hypertensive, anti-inflammatory, and especially anti-cancer effects. For a more in-deep understanding of the CBD mechanism associated with cancer, the authors had demonstrated the potential of CBD against various cancer types, especially the signaling pathway underlying of CBD’s potential as an anticancer agent based on in vitro and in vivo studies. The present article provided information on how CBD can interact with many forms of cellular targeting that contributed to the modulation of the notable cancer pathway, such as MAPK, PI3K, and Wnt signaling pathways. These would lead to inhibiting cell survival, inducing apoptosis, exerting a cytotoxic effect, or arresting the cycle of cancer cells. Furthermore, the present article had been carried out on the pre-clinical data possibility of CBD as a natural plant for their anticancer property. However, demand further scientific research is needed.\u0000\u0000Keywords: Human Cancer Signaling; Cannabidiol (CBD); Chemopreventive agent","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84528035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Condylar Offset Ratio and Anterior Femoral Cut between Anterior and Posterior Referencing Systems in Total Knee Arthroplasty","authors":"","doi":"10.35755/jmedassocthai.2023.02.13777","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13777","url":null,"abstract":"Background: The postoperative posterior condylar offset ratio (PCOR) and the anterior femoral cut (AFC) after total knee arthroplasty in the anterior referencing system (ARS) and posterior referencing system (PRS) are controversial.\u0000\u0000Objective: To compare PCOR and AFC in both referencing systems.\u0000\u0000Materials and Methods: The present study was a retrospective study that included 331 patients with 443 knees that underwent primary PSTKA. The patients were divided into two groups according to the referencing system. One hundred four knees were selected for the ARS and 104 knees were selected for the PRS by using the systematic sampling method. Preoperative PCOR, postoperative PCOR, and AFC were measured and compared in each group and between groups.\u0000\u0000Results: Preoperative PCOR and postoperative PCOR in the ARS and PRS were 0.47 (SD 0.04). Postoperative PCOR in the ARS and PRS were not significantly different (p=0.43). The gaps between the tip of the anterior flange of the femoral component and anterior femoral cortex were 24.04% in the ARS and 28.85% in the PRS, with no statistically significant difference (p=0.43). Anterior femoral notching was not found in either group.\u0000\u0000Conclusion: Both ARS and PRS could preserve the PCOR and showed no statistically significant difference in the AFC after total knee arthroplasty.\u0000\u0000Keywords: Posterior condylar offset ratio; Anterior referencing system; Posterior referencing system; Anterior femoral cut; Total knee arthroplasty","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90606993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Cream Containing Dipotassium Glycyrrhizinate, Vaccinium myrtillius, Epigallocatechin Gallatyl Glucoside, and Tamarindus indica Compared with Triamcinolone Acetonide Cream in Eczema and Psoriasis","authors":"","doi":"10.35755/jmedassocthai.2023.02.13745","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13745","url":null,"abstract":"Background: Topical corticosteroids are the main treatment in eczema and psoriasis. However, long-term use of corticosteroids causes unwanted adverse effects. Dipotassium glycyrrhizinate (DPG) HERB cream, containing DPG, Vaccinium myrtillius, epigallocatechin gallatyl glucoside, and Tamarindus indica, has an anti-inflammatory and antioxidant effect by inhibiting histamine release and proinflammatory cytokine production so a natural herbal cream is required for alternative treatment.\u0000\u0000Objective: To evaluate the efficacy and safety of DPG-HERB.\u0000\u0000Materials and Methods: The present study was a right-left, double-blinded, randomized clinical trial in participants with eczema or plaque psoriasis on both sides of the body. DPG-HERB was applied to the lesion on one side of the body, while 0.1% triamcinolone acetonide (TA) cream was applied to the lesion on the other side, twice daily for four weeks. Disease severity as eczema area and severity index (EASI) in eczema, and psoriasis area and severity index (PASI) in psoriasis, skin biophysics as corneometry and transepidermal water loss (TEWL), and clinical assessments as erythema, scale or excoriation, and lichenification or thickness, were evaluated at baseline, week 2 and week 4 after treatment. The dermatology life quality index (DLQI) was performed at baseline and week 4. Adverse effects were recorded during each visit.\u0000\u0000Results: The evaluation of the 75 patients with 150 lesions in the present study, DPG-HERB and TA cream showed significant improvement in all the evaluated characteristics of eczema (p<0.05), however, in psoriasis, both creams showed significant improvement in skin biophysics, PASI, scale, and thickness (p<0.05), but DPG-HERB was less effective in decreasing erythema (DPG-HERB, p=0.31 and TA, p<0.05) and less improving TEWL compared with 0.1% TA cream (DPG-HERB, p=0.051 and TA, p<0.05). No side effects in the short-term period were reported in either group.\u0000\u0000Conclusion: DPG-HERB is safe and efficacious in eczema, but less effective in psoriasis comparing to TA cream.\u0000\u0000Keywords: Eczema; Plaque psoriasis; Dipotassium glycyrrhizinate acid","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88370153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Costs of Hemiarthroplasty in Patients with Osteoporotic Femoral Neck Fracture at Faculty of Medicine Siriraj Hospital","authors":"","doi":"10.35755/jmedassocthai.2023.02.13680","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13680","url":null,"abstract":"Background: The medical cost of osteoporotic hip fracture has become a great burden for the healthcare system. In Thailand, studies on the costs of bipolar hemiarthroplasty treatment for osteoporotic femoral neck fractures are limited and not up to date.\u0000\u0000Objective: To evaluate the in-hospital costs of treating the elderly with osteoporotic femoral neck fractures receiving hemiarthroplasty treatment.\u0000\u0000Materials and Methods: Patients with hip fractures who were 60 years or older and underwent bipolar hemiarthroplasty were prospectively observed. All patients were managed according to the Siriraj hip fracture fast-track and Fracture Liaison Service protocols. The authors collected details of the in-hospital costs incurred during the admission period and identified factors associated with an increasing in these costs.\u0000\u0000Results: Between February 1 and July 31, 2020, 50 patients were enrolled in the present study. Their average age was 78.3 years, and most had a Charlson comorbidity index of more than 5. The median total in-hospital costs for treatment were 5,013.25 USD with a range of 3,695.05 to 13,193.77 USD. Most of the total in-hospital costs occurred intraoperatively, with 29% of the total costs related to the cost of a prosthesis. The factors associated with an increase in costs were the length of stay (probability p<0.001) and postoperative pneumonia (p=0.038).\u0000\u0000Conclusion: In-hospital costs of hip fracture have become a great burden for patients and caregivers. Strategies to reduce total costs during hospitalization should focus on early surgery coupled with rehabilitation, which results in shorter stays.\u0000\u0000Keywords: Cost analysis; Femoral neck fracture; Hemiarthroplasty; In-hospital costs","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84168276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Cervical Neural Foramen Stenosis Grading Based on Axial Three-Dimensional Magnetic Resonance Images","authors":"","doi":"10.35755/jmedassocthai.2023.02.13783","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13783","url":null,"abstract":"Objective: To assess the reliability of cervical neural foramen stenosis (CNFS) grading by using three-dimensional (3D) T1W, 3D T2W, and twodimensional (2D) T2W images in axial plane.\u0000\u0000Materials and Methods: The authors enrolled 32 patients between December 2019 and February 2020 who underwent cervical spine magnetic resonance imaging (MRI) with clinical manifestations of cervical spondylosis. Two blinded radiologists interpreted the axial 3D T1W TSE, 3D T2W TSE, and 2D T2W TSE images using a 4-point visual scale for CNFS grading in all cervical levels. Intra-observer agreement of CNFS grading on the three imaging pulse sequences for each observer and inter-observer agreement between both observers were analyzed using intra-class correlation coefficient (ICC).\u0000\u0000Results: Three hundred eighty-four neural foramina were evaluated. The overall mean intra-observer agreement of CNFS grading was strong on the axial 3D T1W TSE, 3D T2W TSE, and 2D T2W TSE images for each observer with ICC values of 0.79 and 0.82. The overall mean inter-observer agreement for CNFS grading was strong on 3D T1W TSE, 3D T2W TSE, and 2D T2W TSE images with ICC values of 0.79, 0.79, and 0.86, respectively.\u0000\u0000Conclusion: Axial 3D T1W TSE, 3D T2W TSE, and 2D T2W TSE images exhibited comparable strong reliability in the grading of cervical neural foramen stenosis without the significant benefit of 3D over 2D technique.\u0000\u0000Keywords: Cervical spine; Neural foramen stenosis; MRI; Grading","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83655266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications, Reasons for Reoperation, and 5-Year Prosthesis Survival Compared between the Cemented and Cementless Oxford Unicompartmental Knee Arthroplasty in Thai Patients","authors":"","doi":"10.35755/jmedassocthai.2023.02.13785","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13785","url":null,"abstract":"Background: Oxford unicompartmental knee arthroplasty (OUKA) yields favorable outcomes in patients with medial compartmental knee osteoarthritis. However, it remains unknown whether cemented or cementless OUKA fixation delivers better outcomes in Asian population.\u0000\u0000Objective: To investigate the complications, reasons for reoperation, and 5-year prosthesis survival compared between cemented and cementless OUKA in Thai patients.\u0000\u0000Materials and Methods: Four hundred sixty-six cemented and 36 cementless OUKA performed between 2011 and 2015 with a minimum follow-up of five years were included. With reoperation for any reason as the endpoint, Kaplan-Meier analysis was performed to compare 5-year implant survival between groups. Complications, reasons for reoperation, and 90-day morbidity and mortality were compared between groups. Cox proportional hazards model was used to identify independent predictors of implant survival.\u0000\u0000Results: There was no significant difference in 5-year implant survival between the cemented and the cementless groups at 96.4% versus 94.4% (p=0.375). The mean implant survival time was 113.0±0.8 and 70.8±1.9 months in the cemented and the cementless groups, respectively (p=0.383). The most common reason for reoperation was bearing dislocation, and only one patient had 90-day morbidity. There was no significant difference between groups for complications or reasons for reoperation. No independent predictors of implant survival were identified in multivariate analysis.\u0000\u0000Conclusion: OUKA was shown to be a safe and durable reconstructive procedure in Thai patients with medial compartmental knee osteoarthritis. There was no significant difference in implant survival between the cemented and the cementless groups during the 5-year follow-up, and no independent predictors of implant survival were identified.\u0000\u0000Trial registration: Thai Clinical Trials Registry, TCTR20200427004, registered 27 April 2020, retrospectively registered\u0000\u0000Keywords: Complications; Reasons for reoperation; 5-year implant survival; Oxford unicompartmental knee arthroplasty (OUKA); Thailand","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82048277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events of BNT162b2 (Pfizer) COVID-19 Vaccine in Children Aged 12 to 17 Years in Thailand","authors":"C. Singkiao","doi":"10.35755/jmedassocthai.2023.02.13748","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13748","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) has been sabotaging the world over the last two years and vaccine is one of the key solutions. However, the concerns over its side effects can cause vaccine refusal, subsequently affecting many countries’ education system recovery plans.\u0000\u0000Objective: To actively evaluate adverse effects and their severity following COVID-19 immunization among schoolchildren aged 12 to 17 years, to support parents’ decision-making.\u0000\u0000Materials and Methods: The present study was an observational study whereby a Google-form survey on Pfizer COVID-19 vaccine adverse effects (CVAE) was responded between January and April 2022 by 537 participants. Descriptive statistics were used to analyze basic characteristics. Chi-square tests were performed for comparative analyses between junior (aged 12 to 15 years) versus senior (aged 16 to 17 years) high school students, and McNemar’s test for the first dose versus second dose groups analysis with a significance level set at p-value less than 0.05.\u0000\u0000Results: At least one CVAE was reported in 93.85% of the included participants, albeit mostly mild. The most common symptom as a local event was tenderness at the puncture site (82.50%), whereas systemic events were predominated by myalgia (74.67%). The second dose was associated with increased frequency and severity of adverse effects compared to the first dose (p<0.001). The older age group had significantly more side effects compared to the younger group (p<0.05).\u0000\u0000Conclusion: The high incidence of CVAEs in schoolchildren was predominated by mild symptoms, with the second dose and older group associated with increased frequency of symptoms. The predominance of mild symptoms found in the present study may help reduce the concerns of parents over CVAEs, ultimately accelerating vaccine coverage in the children group, which is still a gap in vaccine administration.\u0000\u0000Keywords: Coronavirus 2019; COVID-19 Vaccine; BNT162b2; Side effects; Adverse events; Adolescence","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73812188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virological Outcome in Newly Adult HIV Cases on Rapid ART initiation in Thailand, A Retrospective Study","authors":"","doi":"10.35755/jmedassocthai.2023.02.13774","DOIUrl":"https://doi.org/10.35755/jmedassocthai.2023.02.13774","url":null,"abstract":"Background: Same day or rapid ART initiation was suitable for asymptomatic HIV stage. Studies have shown benefits in faster virological suppression and reduction of loss to follow up rate.\u0000\u0000Objective: To compare virological outcome at 24 and 72 weeks in adult HIV infection starting ART within two weeks as the rapid ART group, or more than two weeks as the standard care group.\u0000\u0000Materials and Methods: A retrospective cohort study was conducted at Chiangrai Prachanukroh Hospital, Chiangrai, Thailand. All new cases of patients diagnosed with HIV infection between October 1, 2012 and September 30, 2019 were included. The study included demographic data and virological outcome at 24 weeks and 72 weeks, status of loss to follow up or death.\u0000\u0000Results: One thousand seven new adult HIV cases were reviewed. Mean age was 34.03±11.27 years old. Male was predominant at 70.51%, mode of transmission was heterosexual at 87.49%. Median CD4 of cases was 268 cells/mm³. Of all the cases. 36.6% of cases were prescribed ART within 14 days with a median of eight days. NNRTI base regimen was given in 93.64% of the cases. Virological suppression less than 40 copies/mL at 24 weeks was 84.94% in rapid ART group compared with 82.92% in standard group. There was no statistical difference between the groups (p=0.747). Virological suppression less than 40 copies/mL at 72 weeks was 97.14% in rapid ART group compared with 93.84% in standard group, with no statistical difference (p=0.079). Retention to care was higher in rapid ART groups (p=0.012) and mortality rate was lower in rapid ART group (p=0.003). Loss to follow up rate was not different between the groups.\u0000\u0000Conclusion: There was no differences in virological outcome and loss to follow up between the rapid ART and standard groups, but there was better retention to care and lower mortality rate in the rapid ART group.\u0000\u0000Keywords: Adult; HIV; Rapid ART; Virological outcome; LTFU; Thailand","PeriodicalId":17486,"journal":{"name":"Journal of the Medical Association of Thailand = Chotmaihet thangphaet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73859347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}