| Title: |
Second-line HIV therapy outcomes and determinants of mortality at the largest HIV referral center in Southern Vietnam |
| Authors: |
Thao, VP; Quang, VM; Wolbers, M; Anh, ND; Shikuma, C; Farrar, J; Dunstan, S; Chau, NVV; Day, J; Thwaites, G; Le, T |
| Publisher Information: |
LIPPINCOTT WILLIAMS & WILKINS |
| Publication Year: |
2015 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
The growing numbers of HIV-infected patients requiring second-line antiretroviral therapy (ART) in Vietnam make essential the evaluation of treatment efficacy to guide treatment strategies.We evaluated all patients aged ≥15 years who initiated second-line ART after documented failure of first-line therapy at the Hospital for Tropical Diseases in Ho Chi Minh City. The primary outcome was time from second-line ART initiation to death, or to a new or reoccurrence of a WHO-defined immunological or clinical failure event, whichever occurred first. Risks of treatment failure and death were evaluated using Cox proportional hazards modeling.Data from 326 of 373 patients initiating second-line ART between November 2006 and August 2011 were included in this analysis. The median age was 32 years (IQR: 28-36). Eighty one percent were men. The median CD4 count was 44 cells/μL (IQR: 16-84). During a median follow-up of 29 months (IQR: 15-44), 60 (18.4%) patients experienced treatment failure, including 12 immunological failures, 4 WHO stage IV AIDS events, and 44 deaths (13.5%). Sixty percent of deaths occurred during the first 6-12 months. The Kaplan-Meier estimates of treatment failure after 1, 2, 3, and 4 years were 13.1% (95% CI: 9.2-16.8), 18.6% (95% CI: 14.0-23.1), 20.4% (95% CI: 15.4-25.1), and 22.8% (95% CI: 17.2-28.1), respectively. Older age, history of injection drug use, lower CD4 count, medication adherence |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0025-7974 |
| Relation: |
https://hdl.handle.net/11343/261789 |
| Availability: |
https://hdl.handle.net/11343/261789 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; CC BY |
| Accession Number: |
edsbas.EDD6B1A5 |
| Database: |
BASE |