Evidence map›Paper›PMID 27749514›Full record

Trial reportTherapeutic drug monitoring2016

Therapeutic Drug Monitoring of Lopinavir in HIV-Infected Children on Second-Line Antiretroviral Therapy in Asia.

Linda Aurpibul, Sirinya Teerananchai, Wasana Prasitsuebsai, Tavitiya Sudjaritruk, Pope Kosalaraksa, Nia Kurniati, Khanh Huu Truong, Viet Chau Do, Lam Van Nguyen, Kulkanya Chokephaibulkit and 2 more

Open access · greenAbstract readClinical Trial
In one paragraph

Trial report in Therapeutic drug monitoring, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 4 countries.

Linda Aurpibul*Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand; †The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand; ‡Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; §Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand; ¶Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; ‖Children's Hospital 1, Ho Chi Minh City, Vietnam; **Children's Hospital 2, Ho Chi Minh City, Vietnam; ††National Hospital of Pediatrics, Hanoi, Vietnam; ‡‡Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; §§TREAT Asia/amfAR-The Foundation for AIDS Research, Bangkok, Thailand; ¶¶The Kirby Institute, UNSW Australia, Sydney, Australia; and ‖‖Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.
Sirinya Teerananchai
Wasana Prasitsuebsai
Tavitiya Sudjaritruk
Pope Kosalaraksa
Nia Kurniati
Khanh Huu Truong
Viet Chau Do
Lam Van Nguyen
Kulkanya Chokephaibulkit
Thida Singtoroj
Stephen J Kerr
Chiang Mai University · THHIV Netherlands Australia Thailand Research Collaboration · THAmsterdam Institute for Global Health and Development · NLChildren's Hospital 1 · VNChildren's Hospital 2 · VNKhon Kaen University · THNational Hospital of Pediatrics · VNRumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo · IDSiriraj Hospital · TH

Funding

The Asia-Pacific HIV Research CollaborationU01AI069907 · NIAID · FOUNDATION FOR AIDS RESEARCH · PI ANNETTE H SOHN · 2006 to 2026
$44.8M
NIAID NIH HHS U01 AI069907
6 · The paper itself

Abstract

backgroundFailure rates of second-line boosted protease inhibitor antiretroviral therapy regimens in children rise over time. Therapeutic drug monitoring can contribute to assessments of adherence. The authors assessed the performance characteristics of the US DHHS-recommended lopinavir (LPV) concentration of 1.0 mg/L for predicting virologic failure (VF) and intermediate- to high-level LPV resistance in Asian children.

methodsLPV concentration, HIV RNA level, and adherence data from study participants in Thailand, Vietnam, and Indonesia receiving second-line LPV-based ART and followed for ≥24 weeks were analyzed.

resultsA total of 223 children at a median age of 10.4 (interquartile range, 7.9-13.4) years were enrolled, and 61% of them were male. Their mean CD4 was 842 ± 438 cells per cubic millimeter, and the median LPV duration was 2.5 (interquartile range, 1.3-4.2) years. Five of 84 (6%) and 18 of 139 (13%) children had LPV trough and random concentrations <1.0 mg/L at study week 24. Using either of these trough or random LPV concentrations, a cutoff at 1.0 mg/L gave an area under the receiver operating characteristics curve of 0.69 in predicting VF with sensitivity of 44% (95% CI 23-66) and specificity of 94% (95% CI 89-97). Seven of 21 with VF and resistance results available had ≥1 major protease inhibitor mutation. Multivariate logistic regression found LPV concentrations <1.0 mg/L (odds ratio, 6.47; 95% CI 2.15-19.50, P = 0.001) and CD4 ≤20% (odds ratio, 2.83; 95% CI 1.01-7.89, P = 0.05) were independently associated with HIV RNA >1000 copies per milliliter. No factors predicted major LPV resistance mutations.

conclusionsThe authors support that the DHHS target LPV concentration of <1.0 mg/L is predictive of VF, but not of the presence of major LPV mutations.

Indexed as

AdolescentAnti-Retroviral AgentsAsiaChildDrug MonitoringFemaleHIV-1HIV InfectionsHumansLopinavirMaleViral LoadAnti-Retroviral AgentsLopinavir

Identifiers

PMID27749514
PMCPMC5112108
OpenAlexW2528519956

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.