PMID- 31179641
OWN - NLM
STAT- MEDLINE
DCOM- 20200401
LR  - 20231012
IS  - 1758-2652 (Electronic)
IS  - 1758-2652 (Linking)
VI  - 22
IP  - 6
DP  - 2019 Jun
TI  - Impact of the frequency of plasma viral load monitoring on treatment outcomes 
      among children with perinatally acquired HIV.
PG  - e25312
LID - 10.1002/jia2.25312 [doi]
LID - e25312
AB  - INTRODUCTION: Recommendations on the optimal frequency of plasma viral load (pVL) 
      monitoring in children living with HIV (CLWH) who are stable on combination 
      antiretroviral therapy (cART) are inconsistent. This study aimed to determine the 
      impact of annual versus semi-annual pVL monitoring on treatment outcomes in Asian 
      CLWH. METHODS: Data on children with perinatally acquired HIV aged <18 years on 
      first-line, non-nucleoside reverse transcriptase inhibitor-based cART with viral 
      suppression (two consecutive pVL <400 copies/mL over a six-month period) were 
      included from a regional cohort study; those exposed to prior mono- or dual 
      antiretroviral treatment were excluded. Frequency of pVL monitoring was 
      determined at the site-level based on the median rate of pVL measurement: annual 
      0.75 to 1.5, and semi-annual >1.5 tests/patient/year. Treatment failure was 
      defined as virologic failure (two consecutive pVL >1000 copies/mL), change of 
      antiretroviral drug class, or death. Baseline was the date of the second 
      consecutive pVL <400 copies/mL. Competing risk regression models were used to 
      identify predictors of treatment failure. RESULTS: During January 2008 to March 
      2015, there were 1220 eligible children from 10 sites that performed at least 
      annual pVL monitoring, 1042 (85%) and 178 (15%) were from sites performing annual 
      (n = 6) and semi-annual pVL monitoring (n = 4) respectively. Pre-cART, 675 
      children (55%) had World Health Organization clinical stage 3 or 4, the median 
      nadir CD4 percentage was 9%, and the median pVL was 5.2 log(10) copies/mL. At 
      baseline, the median age was 9.2 years, 64% were on nevirapine-based regimens, 
      the median cART duration was 1.6 years, and the median CD4 percentage was 26%. 
      Over the follow-up period, 258 (25%) CLWH with annual and 40 (23%) with 
      semi-annual pVL monitoring developed treatment failure, corresponding to 
      incidence rates of 5.4 (95% CI: 4.8 to 6.1) and 4.3 (95% CI: 3.1 to 5.8) per 100 
      patient-years of follow-up respectively (p = 0.27). In multivariable analyses, 
      the frequency of pVL monitoring was not associated with treatment failure 
      (adjusted hazard ratio: 1.12; 95% CI: 0.80 to 1.59). CONCLUSIONS: Annual compared 
      to semi-annual pVL monitoring was not associated with an increased risk of 
      treatment failure in our cohort of virally suppressed children with perinatally 
      acquired HIV on first-line NNRTI-based cART.
CI  - (c) 2019 The Authors. Journal of the International AIDS Society published by John 
      Wiley & Sons Ltd on behalf of the International AIDS Society.
FAU - Sudjaritruk, Tavitiya
AU  - Sudjaritruk T
AUID- ORCID: 0000-0002-3686-4623
AD  - Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 
      Thailand.
AD  - Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 
      Thailand.
FAU - Boettiger, David C
AU  - Boettiger DC
AD  - The Kirby Institute, UNSW Australia, Sydney, Australia.
FAU - Nguyen, Lam Van
AU  - Nguyen LV
AD  - National Hospital of Pediatrics, Hanoi, Vietnam.
FAU - Mohamed, Thahira J
AU  - Mohamed TJ
AD  - Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
FAU - Wati, Dewi K
AU  - Wati DK
AD  - Sanglah Hospital, Udayana University, Bali, Indonesia.
FAU - Bunupuradah, Torsak
AU  - Bunupuradah T
AD  - HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
FAU - Hansudewechakul, Rawiwan
AU  - Hansudewechakul R
AD  - Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
FAU - Ly, Penh S
AU  - Ly PS
AD  - National Centre for HIV/AIDS, Dermatology and STDs, Phnom Penh, Cambodia.
FAU - Lumbiganon, Pagakrong
AU  - Lumbiganon P
AD  - Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 
      Thailand.
FAU - Nallusamy, Revathy A
AU  - Nallusamy RA
AD  - Penang Hospital, Penang, Malaysia.
FAU - Fong, Moy S
AU  - Fong MS
AD  - Hospital Likas, Kota Kinabalu, Malaysia.
FAU - Chokephaibulkit, Kulkanya
AU  - Chokephaibulkit K
AD  - Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol 
      University, Bangkok, Thailand.
FAU - Nik Yusoff, Nik K
AU  - Nik Yusoff NK
AD  - Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.
FAU - Truong, Khanh H
AU  - Truong KH
AD  - Children's Hospital 1, Ho Chi Minh City, Vietnam.
FAU - Do, Viet C
AU  - Do VC
AD  - Children's Hospital 2, Ho Chi Minh City, Vietnam.
FAU - Sohn, Annette H
AU  - Sohn AH
AUID- ORCID: 0000-0002-0209-3285
AD  - TREAT Asia/amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
FAU - Sirisanthana, Virat
AU  - Sirisanthana V
AD  - Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 
      Thailand.
CN  - TREAT Asia Pediatric HIV Observational Database of IeDEA Asia-Pacific
LA  - eng
GR  - U01 AI069907/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - Switzerland
TA  - J Int AIDS Soc
JT  - Journal of the International AIDS Society
JID - 101478566
RN  - 0 (Anti-HIV Agents)
RN  - 99DK7FVK1H (Nevirapine)
SB  - IM
MH  - Adolescent
MH  - Anti-HIV Agents/*therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Child
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - HIV Infections/*drug therapy/transmission
MH  - Humans
MH  - *Infectious Disease Transmission, Vertical
MH  - Male
MH  - Nevirapine/*therapeutic use
MH  - Treatment Outcome
MH  - *Viral Load
PMC - PMC6556679
OTO - NOTNLM
OT  - Asia
OT  - antiretroviral treatment
OT  - monitoring
OT  - paediatric
OT  - treatment failure
OT  - viral load
FIR - Tucker, J
IR  - Tucker J
FIR - Kumarasamy, N
IR  - Kumarasamy N
FIR - Chandrasekaran, E
IR  - Chandrasekaran E
FIR - Vedaswari, D
IR  - Vedaswari D
FIR - Ramajaya, I B
IR  - Ramajaya IB
FIR - Kurniati, N
IR  - Kurniati N
FIR - Muktiarti, D
IR  - Muktiarti D
FIR - Lim, M
IR  - Lim M
FIR - Daut, F
IR  - Daut F
FIR - Mohamad, P
IR  - Mohamad P
FIR - Drawis, M R
IR  - Drawis MR
FIR - Chan, K C
IR  - Chan KC
FIR - Aurpibul, L
IR  - Aurpibul L
FIR - Hansudewechakul, R
IR  - Hansudewechakul R
FIR - Ounchanum, P
IR  - Ounchanum P
FIR - Denjanta, S
IR  - Denjanta S
FIR - Kongphonoi, A
IR  - Kongphonoi A
FIR - Kosalaraksa, P
IR  - Kosalaraksa P
FIR - Tharnprisan, P
IR  - Tharnprisan P
FIR - Udomphanit, T
IR  - Udomphanit T
FIR - Jourdain, G
IR  - Jourdain G
FIR - Puthanakit, T
IR  - Puthanakit T
FIR - Anugulruengkit, S
IR  - Anugulruengkit S
FIR - Jantarabenjakul, W
IR  - Jantarabenjakul W
FIR - Nadsasarn, R
IR  - Nadsasarn R
FIR - Lapphra, K
IR  - Lapphra K
FIR - Phongsamart, W
IR  - Phongsamart W
FIR - Sricharoenchai, S
IR  - Sricharoenchai S
FIR - Du, Q T
IR  - Du QT
FIR - Nguyen, C H
IR  - Nguyen CH
FIR - Ha, T M
IR  - Ha TM
FIR - An, V T
IR  - An VT
FIR - Khu, Dtk
IR  - Khu D
FIR - Pham, A N
IR  - Pham AN
FIR - Nguyen, L T
IR  - Nguyen LT
FIR - Le, O N
IR  - Le ON
FIR - Chi, Ho
IR  - Chi H
FIR - Ross, J L
IR  - Ross JL
FIR - Suwanlerk, T
IR  - Suwanlerk T
FIR - Law, M G
IR  - Law MG
FIR - Kariminia, A
IR  - Kariminia A
EDAT- 2019/06/11 06:00
MHDA- 2020/04/02 06:00
PMCR- 2019/06/09
CRDT- 2019/06/11 06:00
PHST- 2018/12/08 00:00 [received]
PHST- 2019/05/09 00:00 [accepted]
PHST- 2019/06/11 06:00 [entrez]
PHST- 2019/06/11 06:00 [pubmed]
PHST- 2020/04/02 06:00 [medline]
PHST- 2019/06/09 00:00 [pmc-release]
AID - JIA225312 [pii]
AID - 10.1002/jia2.25312 [doi]
PST - ppublish
SO  - J Int AIDS Soc. 2019 Jun;22(6):e25312. doi: 10.1002/jia2.25312.