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...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0264157 |
| _version_ | 1797956027163869184 |
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| author | Jung Ho Kim Awachana Jiamsakul Sasisopin Kiertiburanakul Bui Vu Huy Suwimon Khusuwan Nagalingeswaran Kumarasamy Oon Tek Ng Penh Sun Ly Man-Po Lee Yu-Jiun Chan Yasmin Mohamed Gani Iskandar Azwa Anchalee Avihingsanon Tuti Parwati Merati Sanjay Pujari Romanee Chaiwarith Fujie Zhang Junko Tanuma Cuong Duy Do Rossana Ditangco Evy Yunihastuti Jeremy Ross Jun Yong Choi IeDEA Asia-Pacific |
| author_facet | Jung Ho Kim Awachana Jiamsakul Sasisopin Kiertiburanakul Bui Vu Huy Suwimon Khusuwan Nagalingeswaran Kumarasamy Oon Tek Ng Penh Sun Ly Man-Po Lee Yu-Jiun Chan Yasmin Mohamed Gani Iskandar Azwa Anchalee Avihingsanon Tuti Parwati Merati Sanjay Pujari Romanee Chaiwarith Fujie Zhang Junko Tanuma Cuong Duy Do Rossana Ditangco Evy Yunihastuti Jeremy Ross Jun Yong Choi IeDEA Asia-Pacific |
| author_sort | Jung Ho Kim |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-10T23:42:26Z |
| format | Article |
| id | doaj.art-3d1479ada5ce412dbcdab94a76ffd84b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T23:42:26Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3d1479ada5ce412dbcdab94a76ffd84b2023-01-11T05:32:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026415710.1371/journal.pone.0264157Patterns and prognosis of holding regimens for people living with HIV in Asian countries.Jung Ho KimAwachana JiamsakulSasisopin KiertiburanakulBui Vu HuySuwimon KhusuwanNagalingeswaran KumarasamyOon Tek NgPenh Sun LyMan-Po LeeYu-Jiun ChanYasmin Mohamed GaniIskandar AzwaAnchalee AvihingsanonTuti Parwati MeratiSanjay PujariRomanee ChaiwarithFujie ZhangJunko TanumaCuong Duy DoRossana DitangcoEvy YunihastutiJeremy RossJun Yong ChoiIeDEA Asia-PacificThe 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.https://doi.org/10.1371/journal.pone.0264157 |
| spellingShingle | Jung Ho Kim Awachana Jiamsakul Sasisopin Kiertiburanakul Bui Vu Huy Suwimon Khusuwan Nagalingeswaran Kumarasamy Oon Tek Ng Penh Sun Ly Man-Po Lee Yu-Jiun Chan Yasmin Mohamed Gani Iskandar Azwa Anchalee Avihingsanon Tuti Parwati Merati Sanjay Pujari Romanee Chaiwarith Fujie Zhang Junko Tanuma Cuong Duy Do Rossana Ditangco Evy Yunihastuti Jeremy Ross Jun Yong Choi IeDEA Asia-Pacific Patterns and prognosis of holding regimens for people living with HIV in Asian countries. PLoS ONE |
| 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 |
| url | https://doi.org/10.1371/journal.pone.0264157 |
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