PMID- 26950901 OWN - NLM STAT- MEDLINE DCOM- 20160830 LR - 20220318 IS - 1365-3156 (Electronic) IS - 1360-2276 (Print) IS - 1360-2276 (Linking) VI - 21 IP - 5 DP - 2016 May TI - Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD. PG - 662-74 LID - 10.1111/tmi.12690 [doi] AB - OBJECTIVES: Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. METHODS: Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P < 0.10 in univariable analyses were included in multivariable analyses, where P < 0.05 was considered statistically significant. RESULTS: Of 4549 patients from 13 countries in Asia, 3176 (69.8%) were male and the median age was 34 years. A total of 111 (2.4%) had TIs due to AEs and 135 (3.0%) had TIs for other reasons. Median interruption times were 22 days for AE and 148 days for non-AE TIs. In multivariable analyses, interruptions >30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P < 0.001, compared to 0-14 days). Reasons for previous TI were not statistically significant (P = 0.158). CONCLUSIONS: Duration of interruptions of more than 30 days was the key factor associated with large increases in subsequent risk of treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. CI - (c) 2016 John Wiley & Sons Ltd. FAU - Jiamsakul, Awachana AU - Jiamsakul A AD - The Kirby Institute, UNSW Australia, Sydney, Australia. FAU - Kerr, Stephen J AU - Kerr SJ AD - The Kirby Institute, UNSW Australia, Sydney, Australia. AD - HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand. AD - Department of Global Health, Academic Medical Center, University of Amsterdame, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. FAU - Ng, Oon Tek AU - Ng OT AD - Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore City, Singapore. FAU - Lee, Man Po AU - Lee MP AD - Queen Elizabeth Hospital, Hong Kong, China. FAU - Chaiwarith, Romanee AU - Chaiwarith R AD - Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. FAU - Yunihastuti, Evy AU - Yunihastuti E AD - Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia. FAU - Van Nguyen, Kinh AU - Van Nguyen K AD - National Hospital for Tropical Diseases, Hanoi, Vietnam. FAU - Pham, Thuy Thanh AU - Pham TT AD - Bach Mai Hospital, Hanoi, Vietnam. FAU - Kiertiburanakul, Sasisopin AU - Kiertiburanakul S AD - Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. FAU - Ditangco, Rossana AU - Ditangco R AD - Research Institute for Tropical Medicine, Manila, Philippines. FAU - Saphonn, Vonthanak AU - Saphonn V AD - National Center for HIV/AIDS, Dermatology & STDs and University of Health Sciences, Phnom Penh, Cambodia. FAU - Sim, Benedict L H AU - Sim BL AD - Hospital Sungai Buloh, Sungai Buloh, Malaysia. FAU - Merati, Tuti Parwati AU - Merati TP AD - Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia. FAU - Wong, Wingwai AU - Wong W AD - Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Kantipong, Pacharee AU - Kantipong P AD - Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand. FAU - Zhang, Fujie AU - Zhang F AD - Beijing Ditan Hospital, Capital Medical University, Beijing, China. FAU - Choi, Jun Yong AU - Choi JY AD - Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. FAU - Pujari, Sanjay AU - Pujari S AD - Institute of Infectious Diseases, Pune, India. FAU - Kamarulzaman, Adeeba AU - Kamarulzaman A AD - University of Malaya Medical Centre, Kuala Lumpur, Malaysia. FAU - Oka, Shinichi AU - Oka S AD - National Center for Global Health and Medicine, Tokyo, Japan. FAU - Mustafa, Mahiran AU - Mustafa M AD - Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia. FAU - Ratanasuwan, Winai AU - Ratanasuwan W AD - Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. FAU - Petersen, Boondarika AU - Petersen B AD - TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand. FAU - Law, Matthew AU - Law M AD - The Kirby Institute, UNSW Australia, Sydney, Australia. FAU - Kumarasamy, Nagalingeswaran AU - Kumarasamy N AD - YRGCARE Medical Centre, Chennai, India. CN - TREAT Asia HIV Observational Database (TAHOD) LA - eng GR - U01 AI069907/AI/NIAID NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20160329 PL - England TA - Trop Med Int Health JT - Tropical medicine & international health : TM & IH JID - 9610576 RN - 0 (Anti-HIV Agents) SB - IM MH - Adult MH - Anti-HIV Agents/*administration & dosage/*adverse effects/therapeutic use MH - Asia MH - CD4 Lymphocyte Count MH - Disease Progression MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - Female MH - HIV Infections/*drug therapy MH - Humans MH - Male MH - Medication Adherence/psychology/*statistics & numerical data MH - Middle Aged MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Failure MH - Treatment Outcome MH - Viral Load PMC - PMC4959847 MID - NIHMS798938 OTO - NOTNLM OT - Asia OT - Asie OT - HIV OT - VIH OT - adverse events OT - antiretroviral OT - antirretroviral OT - antiretroviral OT - effets indesirables OT - eventos adversos OT - interrupcion del tratamiento OT - interruptions de traitement OT - treatment interruptions FIR - Mean, Cv IR - Mean C FIR - Khol, V IR - Khol V FIR - Zhao, Hx IR - Zhao H FIR - Han, N IR - Han N FIR - Li, Pck IR - Li P FIR - Lam, W IR - Lam W FIR - Chan, Yt IR - Chan Y FIR - Saghayam, S IR - Saghayam S FIR - Ezhilarasi, C IR - Ezhilarasi C FIR - Joshi, K IR - Joshi K FIR - Gaikwad, S IR - Gaikwad S FIR - Chitalikar, A IR - Chitalikar A FIR - Wirawan, Dn IR - Wirawan D FIR - Yuliana, F IR - Yuliana F FIR - Imran, D IR - Imran D FIR - Widhani, A IR - Widhani A FIR - Tanuma, J IR - Tanuma J FIR - Nishijima, T IR - Nishijima T FIR - Na, S IR - Na S FIR - Kim, Jm IR - Kim J FIR - Gani, Ym IR - Gani Y FIR - David, R IR - David R FIR - Omar, Sf Syed IR - Omar SS FIR - Ponnampalavanar, S IR - Ponnampalavanar S FIR - Azwa, I IR - Azwa I FIR - Nordin, N IR - Nordin N FIR - Uy, E IR - Uy E FIR - Bantique, R IR - Bantique R FIR - Ku, Ww IR - Ku W FIR - Wu, Pc IR - Wu P FIR - Lim, Pl IR - Lim P FIR - Lee, Ls IR - Lee L FIR - Ohnmar, Ps IR - Ohnmar P FIR - Ruxrungtham, K IR - Ruxrungtham K FIR - Avihingsanon, A IR - Avihingsanon A FIR - Chusut, P IR - Chusut P FIR - Sungkanuparph, S IR - Sungkanuparph S FIR - Chumla, L IR - Chumla L FIR - Sanmeema, N IR - Sanmeema N FIR - Sirisanthana, T IR - Sirisanthana T FIR - Kotarathititum, W IR - Kotarathititum W FIR - Praparattanapan, J IR - Praparattanapan J FIR - Kambua, P IR - Kambua P FIR - Sriondee, R IR - Sriondee R FIR - Bui, Vh IR - Bui V FIR - Nguyen, Thd IR - Nguyen T FIR - Cuong, Dd IR - Cuong D FIR - Ha, Hl IR - Ha H FIR - Sohn, Ah IR - Sohn A FIR - Durier, N IR - Durier N FIR - Petersen, B IR - Petersen B FIR - Jiamsakul, A IR - Jiamsakul A FIR - Boettiger, Dc IR - Boettiger D EDAT- 2016/03/08 06:00 MHDA- 2016/08/31 06:00 PMCR- 2017/05/01 CRDT- 2016/03/08 06:00 PHST- 2016/03/08 06:00 [entrez] PHST- 2016/03/08 06:00 [pubmed] PHST- 2016/08/31 06:00 [medline] PHST- 2017/05/01 00:00 [pmc-release] AID - 10.1111/tmi.12690 [doi] PST - ppublish SO - Trop Med Int Health. 2016 May;21(5):662-74. doi: 10.1111/tmi.12690. Epub 2016 Mar 29.