Options for a Second-Line Antiretroviral Regimen for HIV Type 1-Infected Patients Whose Initial Regimen of a Fixed-Dose Combination of Stavudine, Lamivudine, and Nevirapine Fails

Sungkanuparph, Somnuek; Manosuth, Weerawat; Kiertiburanakul, Sasisopin; Piyavong, Bucha; Chumpathat, Noppanath; Chantratita, Wasun

doi:10.1086/510745

Cited by 172 publications

(162 citation statements)

References 31 publications

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“…Our previous study has shown that Y181C and K103N are common drug-resistance mutations after failing the first-line ART in Thailand. 24 To minimize TDR in Thailand, strengthening of HIV care system, supporting patient's adherence to therapy, and prevention of HIV transmission in both HIV-infected and not infected individuals are crucial. Regular surveillance of TDR in Thailand will inform evidence-based decision making regarding NAP.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of Transmitted HIV Drug Resistance in Antiretroviral-Naive Patients Aged less than 25 Years, in Bangkok, Thailand

Sungkanuparph

Pasomsub

Chantratita

2013

J Int Assoc Provid AIDS Care

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Emergence of transmitted HIV drug resistance (TDR) is a concern after global scale-up of antiretroviral therapy (ART). World Health Organization had developed threshold survey method for surveillance of TDR in resource-limited countries. ART in Thailand has been scaling up for >10 years. To evaluate the current TDR in Thailand, a cross-sectional study was conducted among antiretroviral-naive HIV-infected patients aged <25 years who newly visited infectious disease clinic in a university hospital, in 2011. HIV genotypic-resistance test was performed. World Health Organization 2009 surveillance drug-resistance mutations were used to define TDR. Of 50 patients, the prevalence of TDR was 4%. Of 2 patients with TDR, 1 had K103N and the other had Y181C mutations. Transmitted HIV drug resistance is emerging in Thailand after a decade of rapid scale-up of ART. Interventions to prevent TDR at the population level are essentially needed in Thailand. Surveillance for TDR in Thailand has to be regularly performed.

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Section: Discussionmentioning

confidence: 99%

Surveillance of Transmitted HIV Drug Resistance in Antiretroviral-Naive Patients Aged less than 25 Years, in Bangkok, Thailand

Sungkanuparph

Pasomsub

Chantratita

2013

J Int Assoc Provid AIDS Care

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“…The late switching may result in poor response to Tenofovir based regimen which is used for second line in India due to accumulating thymidine associated mutations-TAM's. Many studies from Africa and Thailand [6]- [8], only 8% to 40% of individuals who present with evidence of immunological failure had virological failure and resulted in unnecessary switches to second-line ART.…”

Section: Introductionmentioning

confidence: 99%

Predicting Virological Failure with Immunological Criteria in First Line ART Patients in a Resource Poor Setting

Raja¹,

Chandrasekar²,

Krishnarajasekhar³

et al. 2014

WJA

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Indroduction: National Aids control Organisation in India implementing National AIDS control program uses WHO's immunological criteria to screen virological failure. Using immunological criteria to detect virological failure has to be assessed. Predicting virological failure with immunological criteria in resource limited settings had low sensitivity. Factors that influence the outcome are studied. Methods: Retrospective study in tertiary care centre for HIV and TB, Chennai, India. Out of 35,044 on ART between January 2008 and September 2009, 452 suspected immunological failures were referred. 273 screened for virological failure. Frequency, sensitivity/specificity, positive/negative predictive values, chi-square test, odds-ratio, independent sample t test for viral load greater than 10,000 and 1000 of each immunological criterion using Epi-Info and SPSS version 19. Results: 172 had virological failure (62.09%). Average age of failed was 37.33. Single criteria's sensitivity was 60 to 84 for detecting virolological failure. Two or more criteria had specificity 55 to 79. Combination of two or more criteria increased odds ratio for virological failure. Positive predictive value was above 63 for all criteria. PPV was above 80 to the criterion all three positive. Conclusions: ART naive patients with >95% adherence the sensitivity of immunological criteria to detect virological failure is three times than earlier studies. Combination of criteria is more significantly associated with virological failure. Odds ratio doubled for two or more combination of criteria. Immunological criteria is affordable/acceptable for screening virological failure, with adherence > 95% and longer the duration of ART.

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“…In the developing world, having to move from a first line regimen to a second line regimen increases the cost of ART tenfold (Sukasem et al, 2007;Sungkanuparph et al, 2007;Marconi et al, 2008). At present, third line regimens do not exist, meaning the development of resistance to second line regimens leaves patients without therapeutic options.…”

Section: Integrated Design and Process Technology Idpt 2009mentioning

confidence: 99%

Design and Process Development for Smart Phone Medication Dosing Support System and Educational Platform in Hiv/Aids-Tb Programs in Zambia

Willig¹,

Sinkala²,

Sadasivam³

et al. 2011

Biomedical Engineering

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Options for a Second-Line Antiretroviral Regimen for HIV Type 1-Infected Patients Whose Initial Regimen of a Fixed-Dose Combination of Stavudine, Lamivudine, and Nevirapine Fails

Cited by 172 publications

References 31 publications

Surveillance of Transmitted HIV Drug Resistance in Antiretroviral-Naive Patients Aged less than 25 Years, in Bangkok, Thailand

Surveillance of Transmitted HIV Drug Resistance in Antiretroviral-Naive Patients Aged less than 25 Years, in Bangkok, Thailand

Predicting Virological Failure with Immunological Criteria in First Line ART Patients in a Resource Poor Setting

Design and Process Development for Smart Phone Medication Dosing Support System and Educational Platform in Hiv/Aids-Tb Programs in Zambia

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