Evidence map›Paper›PMID 29243388›Full record

ArticleJournal of the International AIDS Society2017

The treatment outcomes of antiretroviral substitutions in routine clinical settings in Asia; data from the TREAT Asia HIV Observational Database (TAHOD).

In Young Jung, David Boettiger, Wing Wai Wong, Man Po Lee, Sasisopin Kiertiburanakul, Romanee Chaiwarith, Anchalee Avihingsanon, Junko Tanuma, Nagalingeswaran Kumarasamy, Adeeba Kamarulzaman and 7 more

Abstract read
In one paragraph

Article in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. 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

17 authors.

In Young JungDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
David BoettigerThe Kirby Institute, UNSW Sydney, Sydney, Australia.
Wing Wai WongTaipei Veterans General Hospital, Taipei, Taiwan.
Man Po LeeQueen Elizabeth Hospital, Hong Kong, China.
Sasisopin KiertiburanakulFaculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Romanee ChaiwarithResearch Institute for Health Sciences, Chiang Mai, Thailand.
Anchalee AvihingsanonHIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Junko TanumaNational Center for Global Health and Medicine, Tokyo, Japan.
Nagalingeswaran KumarasamyChennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India.
Adeeba KamarulzamanUniversity Malaya Medical Centre, Kuala Lumpur, Malaysia.
Fujie ZhangBeijing Ditan Hospital, Capital Medical University, Beijing, China.
Pacharee KantipongChiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Oon Tek NgTan Tock Seng Hospital, Singapore, Singapore.
Benedict Lim Heng SimHospital Sungai Buloh, Sungai Buloh, Malaysia.
Matthew LawThe Kirby Institute, UNSW Sydney, Sydney, Australia.
Jeremy RossTREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand.
Jun Yong ChoiDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.ORCID 0000-0002-2775-3315

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

introductionAlthough substitutions of antiretroviral regimen are generally safe, most data on substitutions are based on results from clinical trials. The objective of this study was to evaluate the treatment outcomes of substituting antiretroviral regimen in virologically suppressed HIV-infected patients in non-clinical trial settings in Asian countries.

methodsThe study population consisted of HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD). Individuals were included in this analysis if they started combination antiretroviral treatment (cART) after 2002, were being treated at a centre that documented a median rate of viral load monitoring ≥0.8 tests/patient/year among TAHOD enrolees, and experienced a minor or major treatment substitution while on virally suppressive cART. The primary endpoint to evaluate outcomes was clinical or virological failure (VF), followed by an ART class change. Clinical failure was defined as death or an AIDS diagnosis. VF was defined as confirmed viral load measurements ≥400 copies/mL followed by an ART class change within six months. Minor regimen substitutions were defined as within-class changes and major regimen substitutions were defined as changes to a drug class. The patterns of substitutions and rate of clinical or VF after substitutions were analyzed.

resultsOf 3994 adults who started ART after 2002, 3119 (78.1%) had at least one period of virological suppression. Among these, 1170 (37.5%) underwent a minor regimen substitution, and 296 (9.5%) underwent a major regimen substitution during suppression. The rates of clinical or VF were 1.48/100 person years (95% CI 1.14 to 1.91) in the minor substitution group, 2.85/100 person years (95% CI 1.88 to 4.33) in the major substitution group and 2.53/100 person years (95% CI 2.20 to 2.92) among patients that did not undergo a treatment substitution.

conclusionsThe rate of clinical or VF was low in both major and minor substitution groups, showing that regimen substitution is generally effective in non-clinical trial settings in Asian countries.

Indexed as

AdultAnti-HIV AgentsAsiaCohort StudiesDatabases, FactualFemaleHIV InfectionsHumansMaleMiddle AgedTreatment OutcomeViral LoadAnti-HIV AgentsARTAsian countriesclinical failureeffectivenesssubstitutionvirological failure

Identifiers

PMID29243388
PMCPMC5810317

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Registered trials

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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.