ArticleJournal of acquired immune deficiency syndromes (1999)2012
Second-line antiretroviral therapy: long-term outcomes in South Africa.
Article in Journal of acquired immune deficiency syndromes (1999), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 5 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- HIV-1 subtype C predicted co-receptor tropism in Africa: an individual sequence level meta-analysis.AIDS research and therapy · 2020Pooled it
- Second-line HIV treatment failure in sub-Saharan Africa: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Effectiveness of Protease Inhibitor/Nucleos(t)ide Reverse Transcriptase Inhibitor-Based Second-line Antiretroviral Therapy for the Treatment of Human Immunodeficiency Virus Type 1 Infection in Sub-Saharan Africa: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Pooled it
- Pooled it
- Virologic and immunologic outcomes of HIV-infected Ugandan children randomized to lopinavir/ritonavir or nonnucleoside reverse transcriptase inhibitor therapy.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- Article
- Second-line anti-retroviral treatment failure and its predictors among patients with HIV in Ethiopia: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Time to Viral Re-suppression and Its Predictors among Adults on Second-Line Antiretroviral Therapy in South Wollo Zone Public Hospitals: Stratified Cox Model.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Participants Switching to Second-Line Antiretroviral Therapy with Susceptible Virus Display Inferior Adherence and Worse Outcomes: An Observational Analysis.AIDS patient care and STDs · 2021Observational
- Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2020Article
- Article
- High failure rates of protease inhibitor-based antiretroviral treatment in rural Tanzania - A prospective cohort study.PloS one · 2020Observational
- The Impacts of Residential Location on the Risk of HIV Virologic Failure Among ART Users in Durban, South Africa.AIDS and behavior · 2019Article
- Drug resistance and optimizing dolutegravir regimens for adolescents and young adults failing antiretroviral therapy.AIDS (London, England) · 2019Article
- Viral suppression among children and their caregivers living with HIV in western Kenya.Journal of the International AIDS Society · 2019Article
- Third-Line Antiretroviral Therapy Program in the South African Public Sector: Cohort Description and Virological Outcomes.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2019Article
- Outcomes of patients enrolled in an antiretroviral adherence club with recent viral suppression after experiencing elevated viral loads.Southern African journal of HIV medicine · 2019Article
- Research on the treatment effects and drug resistances of long-term second-line antiretroviral therapy among HIV-infected patients from Henan Province in China.BMC infectious diseases · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundCurrently, boosted protease inhibitor-containing regimens are the only option after first-line regimen failure available for patients in most resource-limited settings, yet little is known about long-term adherence and outcomes.
methodsWe enrolled patients with virologic failure (VF) who initiated lopinavir/ritonavir-containing second-line antiretroviral therapy (ART). Medication possession ratios were calculated using pharmacy refill dates. Factors associated with 12-month second-line virologic suppression [viral load (VL) <50 copies/mL] and adherence were determined.
resultsOne hundred six patients (median CD4 count and VL at failure: 153 cells/mm(3) and 28,548 copies/mL, respectively) were enrolled. Adherence improved after second-line ART switch (median adherence 6 months prior, 67%; median adherence during initial 6 months of second-line ART, 100%; P = 0.001). Higher levels of adherence during second-line ART was associated with virologic suppression at month 12 of ART (odds ratio 2.5 per 10% adherence increase, 95% CI 1.3 to 4.8, P = 0.01). Time to virologic suppression was most rapid among patients with 91%-100% adherence compared with patients with 80%-90% and <80% adherence (log rank test, P = 0.01). VF during 24 months of second-line ART was moderate (month 12: 25%, n = 32/126; month 18: 21%, n = 23/112; and month 24: 25%, n = 25/99).
conclusionsThe switch to second-line ART in South Africa was associated with an improvement in adherence, however, a moderate ongoing rate of VF--among approximately 25% of patients receiving second-line ART patients at each follow-up interval--was a cause for concern. Adherence level was associated with second-line ART virologic outcome, helping explain why some patients achieved virologic suppression after switch and others did not.
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