ArticleOpen forum infectious diseases2016
The Effect of Switching to Second-Line Antiretroviral Therapy on the Risk of Opportunistic Infections Among Patients Infected With Human Immunodeficiency Virus in Northern Tanzania.
Article in Open forum infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Brief communication: The rate of switching from first-line to second-line antiretroviral therapy among people living with HIV in Aden City, Yemen.AIDS research and therapy · 2024Article
- Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling-What Can We Learn About Its Factors?Infection and drug resistance · 2023Article
- Delays in third-line antiretroviral therapy and outcomes in North West province.Southern African journal of HIV medicine · 2022Article
- Article
- Emergence of Human Immunodeficiency Virus-1 Drug Resistance During the 3-Month World Health Organization-Recommended Enhanced Adherence Counseling Period in the CART-1 Cohort Study.Open forum infectious diseases · 2021Article
- Delays in repeat HIV viral load testing for those with elevated viral loads: a national perspective from South Africa.Journal of the International AIDS Society · 2020Article
- Increased Mortality With Delayed and Missed Switch to Second-Line Antiretroviral Therapy in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Incidence of tuberculosis in HIV-infected adults on first- and second-line antiretroviral therapy in India.BMC infectious diseases · 2019Article
- Simplifying switch to second-line antiretroviral therapy in sub Saharan Africa: predicted effect of using a single viral load to define efavirenz-based first-line failure.AIDS (London, England) · 2019Article
- Magnitude of delayed turnaround time of laboratory results in Amhara Public Health Institute, Bahir Dar, Ethiopia.BMC health services research · 2019Article
- Incidence of switching to second-line antiretroviral therapy and associated factors in children with HIV: an international cohort collaboration.The lancet. HIV · 2019Article
- Article
- Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Observational
- Second-Line Antiretroviral Therapy in Sub-Saharan Africa: It Is Time to Mind the Gaps.AIDS research and human retroviruses · 2017Article
- Rates of switching to second-line antiretroviral therapy and impact of delayed switching on immunologic, virologic, and mortality outcomes among HIV-infected adults with virologic failure in Rakai, Uganda.BMC infectious diseases · 2017Article
- Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar.Global health action · 2017Article
- Supporting Quality Data Systems: Lessons Learned from Early Implementation of Routine Viral Load Monitoring at a Large Clinic in Lilongwe, Malawi.Journal of clinical research in HIV AIDS and prevention · 2017Article
- Specimen origin, type and testing laboratory are linked to longer turnaround times for HIV viral load testing in Malawi.PloS one · 2017Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
Background. Due to the unintended potential misclassifications of the World Health Organization (WHO) immunological failure criteria in predicting virological failure, limited availability of treatment options, poor laboratory infrastructure, and healthcare providers' confidence in making switches, physicians delay switching patients to second-line antiretroviral therapy (ART). Evaluating whether timely switching and delayed switching are associated with the risk of opportunistic infections (OI) among patients with unrecognized treatment failure is critical to improve patient outcomes. Methods. A retrospective review of 637 adolescents and adults meeting WHO immunological failure criteria was conducted. Timely and delayed switching to second-line ART were defined when switching happened at <3 and ≥3 months, respectively, after failure diagnosis was made. Cox proportional hazard marginal structural models were used to assess the effect of switching to second-line ART on the risk of developing OI. Results. Of 637 patients meeting WHO immunological failure criteria, 396 (62.2%) switched to second-line ART. Of those switched, 230 (58.1%) were delayed. Switching to second-line ART reduced the risk of OI (adjusted hazards ratio [AHR], 0.4; 95% CI, .2-.6). Compared with patients who received timely switch after failure diagnosis was made, those who delayed switching were more likely to develop OI (AHR, 2.2; 95% CI, 1.1-4.3). Conclusion. Delayed switching to second-line ART after failure diagnosis may increase the risk of OI. Serial immunological assessment for switching patients to second-line ART is critical to improve their outcomes.
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