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1. Inappropriateness of Intravenous Antibiotic Prescriptions at Hospital Discharge at a Tertiary Care hospital in Thailand

Author

Mahatumarat T, Pinmanee N, Injai W, and Chaiwarith R

Subjects
parenteral antimicrobials, antimicrobial stewardship, outpatient parenteral antimicrobial therapy, Medicine (General), R5-920
Abstract

Tuanjai Mahatumarat,1 Napaporn Pinmanee,2 Wichchulada Injai,2 Romanee Chaiwarith1 1Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Division of Pharmacy, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Romanee ChaiwarithDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandTel +66-5393-6457Fax +66-5389-4231Email rchaiwar@gmail.comBackground: Intravenous antibiotics, either as outpatient parenteral antimicrobial therapy (OPAT) or transition of care to community-based management, is a common practice in tertiary care hospitals to minimize hospital stays. However, infectious disease consultation was not mandated for those prescriptions. Therefore, we conducted this study to evaluate the appropriateness of intravenous antibiotic prescriptions at hospital discharge.Methods: This retrospective cross-sectional study was conducted among patients receiving care at the internal medicine units of the Maharaj Nakorn Chiang Mai Hospital from November 1, 2015, to April 30, 2016. Intravenous antibiotics at hospital discharge were reviewed by an infectious diseases (ID) specialist.Results: One hundred and twenty-nine prescriptions for 117 patients were reviewed. The most common diagnoses requiring intravenous antibiotics at hospital discharge were upper urinary tract infection (34.2%) and hepatobiliary tract infections (15.4%). The most common intravenous antibiotic was ceftriaxone (36.4%), followed by ertapenem (20.1%). Overall, the inappropriateness of prescriptions was 85.3%. The most common reason for inappropriateness was a failure to switch to oral antibiotics (52.7%), followed by incorrect duration (16.3%).Conclusion: Antimicrobial stewardship should be considered for intravenous antibiotics at hospital discharge to reduce the inappropriateness of those prescriptions.Keywords: parenteral antimicrobials, antimicrobial stewardship, outpatient parenteral antimicrobial therapy

Published
2019

2. WCN23-1041 IMMUNOGENICITY AND SAFETY OF HOMOLOGOUS CHADOX1 NCOV-19 AND HETEROLOGOUS PRIME-BOOST OF CORONAVAC AND CHADOX1 NCOV-19 AMONG KIDNEY TRANSPLANT RECIPIENTS: AN OBSERVATIONAL PROSPECTIVE COHORT STUDY

Author

Narongkiatikhun, P., primary, Ophascharoensuk, V., additional, Chaiwarith, R., additional, Winichakoon, P., additional, Vongsanim, S., additional, Suteeka, Y., additional, Pogsuwan, K., additional, Kusirisin, P., additional, Wongsarikan, N., additional, Khamwan, C., additional, Dankai, D., additional, and Noppakun, K., additional

Published
2023
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3. The occurrence of Simpson's paradox if site-level effect was ignored in the TREAT Asia HIV Observational Database

Author

Ly, P.S., Khol, V., Zhang, F.J., Zhao, H.X., Han, N., Lee, M.P., Li, P.C.K., Lam, W., Chan, Y.T., Kumarasamy, N., Saghayam, S., Ezhilarasi, C., Pujari, S., Joshi, K., Gaikwad, S., Chitalikar, A., Merati, T.P., Wirawan, D.N., Yuliana, F., Yunihastuti, E., Imran, D., Widhani, A., Oka, S., Tanuma, J., Nishijima, T., Choi, J.Y., Na, S., Kim, J.M., Sim, B.L.H., Gani, Y.M., David, R., Kamarulzaman, A., Syed Omar, S.F., Ponnampalavanar, S., Azwa, I., Mustafa, M., Nordin, N., Ditangco, R., Uy, E., Bantique, R., Wong, W.W., Ku, W.W., Wu, P.C., Ng, O.T., Lim, P.L., Lee, L.S., Martinez-Vega, R., Phanuphak, P., Ruxrungtham, K., Avihingsanon, A., Chusut, P., Kiertiburanakul, S., Sungkanuparph, S., Chumla, L., Sanmeema, N., Chaiwarith, R., Sirisanthana, T., Kotarathititum, W., Praparattanapan, J., Kantipong, P., Kambua, P., Ratanasuwan, W., Sriondee, R., Nguyen, K.V., Bui, V.H., Nguyen, D.T.H., Nguyen, D.T., Pham, T.T., Cuong, D.D., Ha, H.L., Sohn, A.H., Durier, N., Petersen, B., Cooper, D.A., Law, M.G., Jiamsakul, A., Boettiger, D.C., Jiamsakul, Awachana, Kerr, Stephen J., Chandrasekaran, Ezhilarasi, Huelgas, Aizobelle, Taecharoenkul, Sineenart, Teeraananchai, Sirinya, Wan, Gang, Ly, Penh Sun, Kiertiburanakul, Sasisopin, and Law, Matthew

Published
2016
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4. HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia‐Pacific region: a longitudinal cohort study

Author

Han, Win Min, Jiamsakul, Awachana, Salleh, Nur Afiqah Mohd, Choi, Jun Yong, Huy, Bui Vu, Yunihastuti, Evy, Do, Cuong Duy, Merati, Tuti P., Gani, Yasmin M., Kiertiburanakul, Sasisopin, Zhang, Fujie, Chan, Yu?Jiun, Lee, Man?Po, Chaiwarith, Romanee, Ng, Oon Tek, Khusuwan, Suwimon, Ditangco, Rossana, Kumarasamy, Nagalingeswaran, Sangle, Shashikala, Ross, Jeremy, Avihingsanon, Anchalee, Ly, Ps, Khol, V, Zhang, Fj, Zhao, Hx, Han, N, Lee, Mp, Li, Pck, Lam, W, Chan, Yt, Kumarasamy, N, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Sangle, S, Mave, V, Marbaniang, I, Nimkar, S, Merati, Tp, Wirawan, Dn, Yuliana, F, Yunihastuti, E, Widhani, A, Maria, S, Karjadi, Th, Oka, S, Nishijima, T, Choi, Jy, Na, S, Kim, Jm, Gani, Ym, Rudi, Nb, Azwa, I, Kamarulzaman, A, Omar, Sf Syed, Ponnampalavanar, S, Ditangco, R, Pasayan, Mk, Mationg, Ml, Chan, Yj, Ku, Ww, Wu, Pc, Ke, E, Ng, Ot, Lim, Pl, Lee, Ls, Liang, D, Avihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Phuphuakrat, A, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Praparattanapan, J, Nuket, K, Khusuwan, S, Kantipong, P, Kambua, P, Nguyen, Kv, Bui, Hv, Nguyen, Dth, Nguyen, Dt, Do, Cd, Ngo, Av, Nguyen, Lt, Sohn, Ah, Ross, Jl, Petersen, B, Law, Mg, Jiamsakul, A, Bijker, R, and Rupasinghe, D

Subjects
Antiviral agents -- Dosage and administration, Intravenous drug abuse -- Complications and side effects -- Care and treatment, HIV infection -- Causes of -- Care and treatment, Health
Abstract

: INTRODUCTION: Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia‐Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS‐defining events and mortality among PWID receiving antiretroviral therapy (ART). METHODS: We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load RESULTS: Of 622 PWID from 12 countries in the Asia‐Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre‐ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year‐10 (n = 78). Higher follow‐up HIV viral load and pre‐ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2‐, 5‐ and 10‐years following ART initiation. There were 52 new AIDS‐defining events and 50 deaths during 3347 person‐years of follow‐up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence CONCLUSIONS: Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings., INTRODUCTION Globally, injecting drug use is a major public health concern leading to substantial health burden and transmission risk of blood‐borne infections from injecting equipment sharing behaviours. In a multi‐stage [...]

Published
2021
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5. Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV

Author

Ku, Stephane Wen?Wei, Jiamsakul, Awachana, Joshi, Kedar, Pasayan, Mark Kristoffer Ungos, Widhani, Alvina, Chaiwarith, Romanee, Kiertiburanakul, Sasisopin, Avihingsanon, Anchalee, Ly, Penh Sun, Kumarasamy, Nagalingeswaran, Do, Cuong D., Merati, Tuti P., Van Nguyen, Kinh, Kamarulzaman, Adeeba, Zhang, Fujie, Lee, Man Po, Choi, Jun Yong, Tanuma, Junko, Khusuwan, Suwimon, Sim, Benedict Lim Heng, Ng, Oon Tek, Ratanasuwan, Winai, Ross, Jeremy, Wong, Wing?Wai, Ly, Ps, Khol, V, Zhang, Fj, Zhao, Hx, Han, N, Lee, Mp, Li, Pck, Lam, W, Chan, Yt, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Sangle, S, Mave, V, Marbaniang, I, Wirawan, Dn, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Oka, S, Nishijima, T, Choi, Jy, S, Na, Kim, Jm, Sim, Blh, Gani, Ym, Rudi, Nb, Kamarulzaman, A, Omar, Sf Syed, Ponnampalavanar, S, Azwa, I, Ditangco, R, Pasayan, Mk, Mationg, Ml, Wong, Ww, Ku, Sww, Wu, Pc, Ng, Ot, Lim, Pl, Lee, Ls, Ferdous, Z, Vihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Phuphuakrat, A, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Khusuwan, S, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, Kv, Bui, Hv, Nguyen, Dth, Nguyen, Dt, Do, Cd, Ngo, Av, Nguyen, Lt, Sohn, Ah, Ross, Jl, Petersen, B, Cooper, Da, Law, Mg, Jiamsakul, A, and Rupasinghe, D

Subjects
Co-trimoxazole -- Statistics -- Complications and side effects, Tuberculosis -- Statistics -- Risk factors, HIV patients -- Statistics -- Drug therapy, Health
Abstract

: Introduction: Cotrimoxazole (CTX) is recommended as prophylaxis against Pneumocystis jiroveci pneumonia, malaria and other serious bacterial infections in HIV‐infected patients. Despite its in vitro activity against Mycobacterium tuberculosis, the effects of CTX preventive therapy on tuberculosis (TB) remain unclear. Methods: Adults living with HIV enrolled in a regional observational cohort in Asia who had initiated combination antiretroviral therapy (cART) were included in the analysis. Factors associated with new TB diagnoses after cohort entry and survival after cART initiation were analysed using Cox regression, stratified by site. Results: A total of 7355 patients from 12 countries enrolled into the cohort between 2003 and 2016 were included in the study. There were 368 reported cases of TB after cohort entry with an incidence rate of 0.99 per 100 person‐years (/100 pys). Multivariate analyses adjusted for viral load (VL), CD4 count, body mass index (BMI) and cART duration showed that CTX reduced the hazard for new TB infection by 28% (HR 0.72, 95% CI l 0.56, 0.93). Mortality after cART initiation was 0.85/100 pys, with a median follow‐up time of 4.63 years. Predictors of survival included age, female sex, hepatitis C co‐infection, TB diagnosis, HIV VL, CD4 count and BMI. Conclusions: CTX was associated with a reduction in the hazard for new TB infection but did not impact survival in our Asian cohort. The potential preventive effect of CTX against TB during periods of severe immunosuppression should be further explored., Introduction Cotrimoxazole (CTX) has been recommended as prophylaxis against Pneumocystis jiroveci pneumonia (PJP), toxoplasmosis, malaria and other serious bacterial infections in adults with severe or advanced HIV clinical disease, with [...]

Published
2019
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6. Disparities in Dolutegravir Uptake Affecting Females of Reproductive Age With HIV in Low- and Middle-Income Countries After Initial Concerns About Teratogenicity : An Observational Study

Author

Romo, M.L., Patel, R.C., Edwards, J.K., Humphrey, J.M., Musick, B.S., Bernard, C., Maina, M.W., Brazier, E., Castelnuovo, B., Penner, J., Wyka, K., Cardoso, S.W., Ly, P.S., Kunzekwenyika, C., Cortés, C.P., Panczak, R., Kelvin, E.A., Wools-Kaloustian, K.K., Nash, D., Khol, V., Zhang, F.J., Zhao, H.X., Han, N., Lee, M.P., Li, P.C.K., Lam, W., Wong, H.Y., Kumarasamy, N., Ezhilarasi, C., Pujari, S., Joshi, K., Gaikwad, S., Chitalikar, A., Merati, T.P., Wirawan, D.N., Yuliana, F., Yunihastuti, E., Imran, D., Widhani, A., Tanuma, J., Oka, S., Nishijima, T., Choi, J.Y., Na, S., Kim, J.M., Gani, Y.M., Rudi, N.B., Azwa, I., Kamarulzaman, A., Syed Omar, S.F., Ponnampalavanar, S., Ditangco, R., Pasayan, M.K., Mationg, M.L., Chan, Y.J., Ku, W.W., Ke, E., Wu, P.C., Ng, O.T., Lim, P.L., Lee, L.S., Yap, J.K., Avihingsanon, A., Gatechompol, S., Phanuphak, P., Phadungphon, C., Kiertiburanakul, S., Phuphuakrat, A., Chumla, L., Sanmeema, N., Chaiwarith, R., Sirisanthana, T., Praparattanapan, J., Nuket, K., Khuwuwan, S., Kantipong, P., Kambua, P., Nguyen, K.V., Bui, H.V., Nguyen, D.T.H., Nguyen, D.T., Do, C.D., Ngo, A.V., Nguyen, L.T., Sohn, A.H., Ross, J.L., Petersen, B., Law, M.G., Jiamsakul, A., Bijker, R., Rupasinghe, D., Cahn, P., Cesar, C., Fink, V., Sued, O., Dell'Isola, E., Perez, H., Valiente, J., Yamamoto, C., Grinsztejn, B., Veloso, V., Luz, P., de Boni, R., Wagner, S.C., Friedman, R., Moreira, R., Pinto, J., Ferreira, F., Maia, M., de Menezes Succi, R.C., Machado, D.M., de Fátima Barbosa Gouvêa, A., Wolff, M., Rodriguez, M.F., Allendes, G., Pape, J.W., Rouzier, V., Marcelin, A., Perodin, C., Luque, M.T., Padgett, D., Madero, J.S., Ramirez, B.C., Belaunzaran, P., Vega, Y.C., Gotuzzo Herencia, José Eduardo, Mejía Cordero, Fernando Alonso, Carriquiry, G., McGowan, C.C., Shepherd, B.E., Sterling, T., Jayathilake, K., Person, A.K., Rebeiro, P.F., Castilho, J., Duda, S.N., Maruri, F., Vansell, H., Jenkins, C., Kim, A., Lotspeich, S., Pélagie, N., Gateretse, P., Munezero, J., Nitereka, V., Niyongabo, T., Twizere, C., Bukuru, H., Nahimana, T., Baransaka, E., Barasukana, P., Kabanda, E., Manirakiza, M., Ndikumwenayo, F., Biziragusenyuka, J., Munezero, A.M.M., Nforniwe, D.N., Ajeh, R., Ngamani, M.L., Dzudie, A., Mbuh, A., Amadou, D., Yone, E.W.P., Kendowo, E., Akele, C., Clever, A., Kitetele, F., Lelo, P., Tabala, M., Ekembe, C., Kaba, D., Diafouka, M., Ekat, M.H., Nsonde, D.M., Mafoua, A., Christ, M.N., Igirimbabazi, J., Ayinkamiye, N., Uwineza, P., Ndamijimana, E., Habarurema, E., Nyiraneza, M.L., Nyiransabimana, M.L., Tuyisenge, L., Shyaka, C., Kankindi, C., Uwakijijwe, B., Ingabire, M.G., Ndumuhire, J., Nyirabahutu, M.G., Muyango, F., Bihibindi, J.C., Uwamahoro, O., Ndoli, Y., Nsanzimana, S., Mugwaneza, P., Remera, E., Umumararungu, E., Rwibasira, G.N., Habimana, D.S., Gasana, J., Kanyabwisha, F., Kubwimana, G., Muhoza, B., Munyaneza, A., Murenzi, G., Musabyimana, F., Umwiza, F., Ingabire, C., Tuyisenge, P., Butera, A.M., Kabahizi, J., Rurangwa, E., Feza, R., Mukashyaka, E., Benekigeri, C., Musaninyange, J., Adedimeji, A., Anastos, K., Dilorenzo, M., Murchison, L., Ross, J., Yotebieng, M., Addison, D., Jones, H., Kulkarni, S., Tymejczyk, O., Elul, B., Cai, X., Dong, A., Hoover, D., Kim, H.-Y., Li, C., Shi, Q., Lancaster, K., Kuniholm, M., Edmonds, A., Parcesepe, A., Edwards, J., Keiser, O., Kimmel, A., Diero, L., Ayaya, S., Sang, E., Bukusi, E., Mulwa, E., Nyanaro, G., Kasozi, C., Ssemakadde, M., Bwana, M.B., Muyindike, W., Byakwaga, H., Kanyesigye, M., Semeere, A., Matovu, J.M., Nalugoda, F., Wasswa, F.X., Kazyoba, P., Mayige, M., Lyamuya, R.E., Mayanga, F., Ngonyani, K., Lwali, J., Urassa, M., Nyaga, C., Machemba, R., Yiannoutsos, C., Vreeman, R., Syvertsen, J., Kantor, R., Martin, J., Wenger, M., Cohen, C., Kulzer, J., Maartens, G., Bolton, C., Wood, R., Sipambo, N., Tanser, F., Boulle, A., Fatti, G., Mbewe, S., Singh, E., Chimbetete, C., Technau, K., Eley, B., Muhairwe, J., Rafael, I., Fox, M.P., Prozesky, H., Anderegg, N., Ballif, M., Ostinelli, C.H.D., Egger, M., Fenner, L., Haas, A., Hossmann, S., Rohner, E., Riou, J., Skrivankova, V., Smith, L., Taghavi, K., von Groote, P., Wandeler, G., Zaniewski, E., Zürcher, K., Anderson, K., Cornell, M., Davies, M.-A., Iyun, V., Johnson, L., Kassanjee, R., Kehoe, K., Kubjane, M., Maxwell, N., Nyakato, P., Patten, G., Tlali, M., Tsondai, P., de Waal, R., and International epidemiology Databases to Evaluate AIDS (IeDEA)

Subjects
Adult, medicine.medical_specialty, Prevention, policy, and public health, Adolescent, Pyridones, Reproductive age, HIV Infections, Choice Behavior, Article, Piperazines, chemistry.chemical_compound, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Epidemiology, Oxazines, Internal Medicine, Medicine, Humans, Maternal Health Services, Cumulative incidence, HIV Integrase Inhibitors, 610 Medicine & health, Developing Countries, Health equity, business.industry, HIV, Contraceptives, General Medicine, Middle Aged, medicine.disease, Antiretroviral therapy, Regimen, Pharmaceutical Preparations, chemistry, Dolutegravir, Observational study, Female, Age groups, Safety, business, Heterocyclic Compounds, 3-Ring, 360 Social problems & social services, Demography, Cohort study
Abstract

BACKGROUND The transition to dolutegravir-containing antiretroviral therapy (ART) in low- and middle-income countries (LMICs) was complicated by an initial safety signal in May 2018 suggesting that exposure to dolutegravir at conception was possibly associated with infant neural tube defects. On the basis of additional evidence, in July 2019, the World Health Organization recommended dolutegravir for all adults and adolescents living with HIV. OBJECTIVE To describe dolutegravir uptake and disparities by sex and age group in LMICs. DESIGN Observational cohort study. SETTING 87 sites that began using dolutegravir in 11 LMICs in the Asia-Pacific; Caribbean, Central and South America network for HIV epidemiology (CCASAnet); and sub-Saharan African regions of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. PATIENTS 134��672 patients aged 16 years or older who received HIV care from January 2017 through March 2020. MEASUREMENTS Sex, age group, and dolutegravir uptake (that is, newly initiating ART with dolutegravir or switching to dolutegravir from another regimen). RESULTS Differences in dolutegravir uptake among females of reproductive age (16 to 49 years) emerged after the safety signal. By the end of follow-up, the cumulative incidence of dolutegravir uptake among females 16 to 49 years old was 29.4% (95% CI, 29.0% to 29.7%) compared with 57.7% (CI, 57.2% to 58.3%) among males 16 to 49 years old. This disparity was greater in countries that began implementing dolutegravir before the safety signal and initially had highly restrictive policies versus countries with a later rollout. Dolutegravir uptake was similar among females and males aged 50 years or older. LIMITATION Follow-up was limited to 6 to 8 months after international guidelines recommended expanding access to dolutegravir. CONCLUSION Substantial disparities in dolutegravir uptake affecting females of reproductive age through early 2020 are documented. Although this disparity was anticipated because of country-level restrictions on access, the results highlight its extent and initial persistence. PRIMARY FUNDING SOURCE National Institutes of Health.

Published
2021
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8. Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti-tuberculosis treatment in HIV/tuberculosis-coinfected patients: results from the TREAT Asia HIV Observational Database

Author

Han, S H, Zhou, J, Lee, M P, Zhao, H, Chen, Y-MA, Kumarasamy, N, Pujari, S, Lee, C, Omar, S FS, Ditangco, R, Phanuphak, N, Kiertiburanakul, S, Chaiwarith, R, Merati, T P, Yunihastuti, E, Tanuma, J, Saphonn, V, Sohn, A H, and Choi, J Y

Published
2014
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9. Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

Author

Boettiger, D.C., primary, Law, M.G., additional, Ross, J., additional, Huy, B.V., additional, Heng, B.S.L., additional, Ditangco, R., additional, Kiertiburanakul, S., additional, Avihingsanon, A., additional, Cuong, D.D., additional, Kumarasamy, N., additional, Kamarulzaman, A., additional, Ly, P.S., additional, Yunihastuti, E., additional, Parwati Merati, T., additional, Zhang, F., additional, Khusuwan, S., additional, Chaiwarith, R., additional, Lee, M.P., additional, Sangle, S., additional, Choi, J.Y., additional, Ku, W.W., additional, Tanuma, J., additional, Ng, O.T., additional, Sohn, A.H., additional, Wester, C.W., additional, Nash, D., additional, Mugglin, C., additional, and Pujari, S., additional

Published
2020
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10. Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific

Author

Rupasinghe, D, primary, Kiertiburanakul, S, additional, Kamarulzaman, A, additional, Zhang, F, additional, Kumarasamy, N, additional, Chaiwarith, R, additional, Merati, TP, additional, Do, CD, additional, Khusuwan, S, additional, Avihingsanon, A, additional, Lee, MP, additional, Ly, PS, additional, Yunihastuti, E, additional, Nguyen, KV, additional, Ditangco, R, additional, Chan, YJ, additional, Pujari, S, additional, Ng, OT, additional, Choi, JY, additional, Sim, BLH, additional, Tanuma, J, additional, Sangle, S, additional, Ross, J, additional, and Law, M, additional

Published
2019
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11. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study

Author

Rohner E., Butikofer L., Schmidlin K., Sengayi M., Maskew M., Giddy J., Garone D., Moore R. D., D'Souza G., Goedert J. J., Achenbach C., Gill M. J., Kitahata M. M., Patel P., Silverberg M. J., Castilho J., McGowan C., Chen Y. -M. A., Law M., Taylor N., Paparizos V., Bonnet F., Verbon A., Fatkenheuer G., Post F. A., Sabin C., Mocroft A., Le Moing V., Dronda F., Obel N., Grabar S., Spagnuolo V., Antinori A., Quiros-Roldan E., Mussini C., Miro J. M., Meyer L., Hasse B., Konopnicki D., Roca B., Barger D., Raben D., Clifford G. M., Franceschi S., Brockmeyer N., Chakraborty R., Egger M., Bohlius J., Judd A., Zangerle R., Touloumi G., Warszawski J., Dabis F., Krause M. M., Ghosn J., Leport C., Wittkop L., Reiss P., Wit F., Prins M., Bucher H., Gibb D., Del Amo J., Thorne C., Kirk O., Stephan C., Perez-Hoyos S., Hamouda O., Bartmeyer B., Chkhartishvili N., Noguera-Julian A., Monforte A. D., Prieto L., Conejo P. R., Soriano-Arandes A., Battegay M., Kouyos R., Tookey P., Casabona J., Castagna A., Konopnick D., Goetghebuer T., Sonnerborg A., Teira R., Garrido M., Haerry D., De Wit S., Costagliola D., D'Arminio-Monforte A., Chene G., Schwimmer C., Termote M., Campbell M., Frederiksen C. M., Friis-Moller N., Kjaer J., Brandt R. S., Berenguer J., Bouteloup V., Cozzi-Lepri A., Davies M. -A., Dorrucci M., Dunn D., Furrer H., Guiguet M., Lambotte O., Leroy V., Lodi S., Matheron S., Monge S., Nakagawa F., Paredes R., Phillips A., Puoti M., Schomaker M., Smit C., Sterne J., Thiebaut R., Torti C., Van Der Valk M., Tanser F., Vinikoor M., MacEte E., Wood R., Stinson K., Fatti G., Phiri S., Chimbetete C., Malisita K., Eley B., Fritz C., Hobbins M., Kamenova K., Fox M., Prozesky H., Technau K., Sawry S., Benson C. A., Bosch R. J., Kirk G. D., Boswell S., Mayer K. H., Grasso C., Hogg R. S., Harrigan P. R., Montaner J. S. G., Yip B., Zhu J., Salters K., Gabler K., Buchacz K., Brooks J. T., Gebo K. 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J., Lau H., Read T., Silvers J., Zeng W., Hoy J., Watson K., Bryant M., Price S., Woolley I., Giles M., Korman T., Williams J., Nolan D., Allen A., Guelfi G., Mills G., Wharry C., Raymond N., Bargh K., Templeton D., Medical Microbiology & Infectious Diseases, Global Health, Infectious diseases, APH - Aging & Later Life, AII - Infectious diseases, APH - Global Health, Graduate School, APH - Digital Health, APH - Personalized Medicine, Bohlius, Julia, Cohere In, Eurocoord, Castagna, Antonella, Rohner, E, Butikofer, L, Schmidlin, K, Sengayi, M, Maskew, M, Giddy, J, Garone, D, Moore, R, D'Souza, G, Goedert, J, Achenbach, C, Gill, M, Kitahata, M, Patel, P, Silverberg, M, Castilho, J, Mcgowan, C, Chen, Y, Law, M, Taylor, N, Paparizos, V, Bonnet, F, Verbon, A, Fatkenheuer, G, Post, F, Sabin, C, Mocroft, A, Le Moing, V, Dronda, F, Obel, N, Grabar, S, Spagnuolo, V, Antinori, A, Quiros-Roldan, E, Mussini, C, Miro, J, Meyer, L, Hasse, B, Konopnicki, D, Roca, B, Barger, D, Raben, D, Clifford, G, Franceschi, S, Brockmeyer, N, Chakraborty, R, Egger, M, Bohlius, J, Judd, A, Zangerle, R, Touloumi, G, Warszawski, J, Dabis, F, Krause, M, Ghosn, J, Leport, C, Wittkop, L, Reiss, P, Wit, F, Prins, M, Bucher, H, Gibb, D, Del Amo, J, Thorne, C, Kirk, O, Stephan, C, Perez-Hoyos, S, Hamouda, O, Bartmeyer, B, Chkhartishvili, N, Noguera-Julian, A, Monforte, A, Prieto, L, Conejo, P, Soriano-Arandes, A, Battegay, M, Kouyos, R, Tookey, P, Casabona, J, Castagna, A, Konopnick, D, Goetghebuer, T, Sonnerborg, A, Teira, R, Garrido, M, Haerry, D, De Wit, S, Costagliola, D, D'Arminio-Monforte, A, Chene, G, Schwimmer, C, Termote, M, Campbell, M, Frederiksen, C, Friis-Moller, N, Kjaer, J, Brandt, R, Berenguer, J, Bouteloup, V, Cozzi-Lepri, A, Davies, M, Dorrucci, M, Dunn, D, Furrer, H, Guiguet, M, Lambotte, O, Leroy, V, Lodi, S, Matheron, S, Monge, S, Nakagawa, F, Paredes, R, Phillips, A, Puoti, M, Schomaker, M, Smit, C, Sterne, J, Thiebaut, R, Torti, C, Van Der Valk, M, Tanser, F, Vinikoor, M, Macete, E, Wood, R, Stinson, K, Fatti, G, Phiri, S, Chimbetete, C, Malisita, K, Eley, B, Fritz, C, Hobbins, M, Kamenova, K, Fox, M, Prozesky, H, Technau, K, Sawry, S, Benson, C, Bosch, R, Kirk, G, Boswell, S, Mayer, K, Grasso, C, Hogg, R, Harrigan, P, Montaner, J, Yip, B, Zhu, J, Salters, K, Gabler, K, Buchacz, K, Brooks, J, Gebo, K, Carey, J, Rodriguez, B, Horberg, M, Thorne, J, Rabkin, C, Margolick, J, Jacobson, L, Klein, M, Rourke, S, Rachlis, A, Cupido, P, Hunter-Mellado, R, Mayor, A, Deeks, S, Martin, J, Saag, M, Mugavero, M, Willig, J, Eron, J, Napravnik, S, Crane, H, Drozd, D, Haas, D, Rebeiro, P, Turner, M, Bebawy, S, Rogers, B, Justice, A, Dubrow, R, Fiellin, D, Gange, S, Anastos, K, Althoff, K, Mckaig, R, Freeman, A, Lent, C, Van Rompaey, S, Morton, L, Mcreynolds, J, Lober, W, Abraham, A, Lau, B, Zhang, J, Jing, J, Modur, S, Wong, C, Hogan, B, Desir, F, Liu, B, You, B, Cahn, P, Cesar, C, Fink, V, Sued, O, Dell'Isola, E, Perez, H, Valiente, J, Yamamoto, C, Grinsztejn, B, Veloso, V, Luz, P, De Boni, R, Wagner, S, Friedman, R, Moreira, R, Pinto, J, Ferreira, F, Maia, M, De Menezes Succi, R, Machado, D, De Fatima Barbosa Gouvea, A, Wolff, M, Cortes, C, Rodriguez, M, Allendes, G, Pape, J, Rouzier, V, Marcelin, A, Perodin, C, Luque, M, Padgett, D, Madero, J, Ramirez, B, Belaunzaran, P, Vega, Y, Gotuzzo, E, Mejia, F, Carriquiry, G, Shepherd, B, Sterling, T, Jayathilake, K, Person, A, Giganti, M, Duda, S, Maruri, F, Vansell, H, Ly, P, Khol, V, Zhang, F, Zhao, H, Han, N, Lee, M, Li, P, Lam, W, Chan, Y, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Merati, T, Wirawan, D, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Oka, S, Nishijima, T, Choi, J, Na, S, Kim, J, Sim, B, Gani, Y, David, R, Kamarulzaman, A, Syed Omar, S, Ponnampalavanar, S, Azwa, I, Ditangco, R, Uy, E, Bantique, R, Wong, W, Ku, W, Wu, P, Ng, O, Lim, P, Lee, L, Ohnmar, P, Avihingsanon, A, Gatechompol, S, Phanuphak, P, Phadungphon, C, Kiertiburanakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, K, Bui, H, Nguyen, D, Cuong, D, An, N, Luan, N, Sohn, A, Ross, J, Petersen, B, Cooper, D, Jiamsakul, A, Boettiger, D, Ellis, D, Bloch, M, Agrawal, S, Vincent, T, Allen, D, Smith, D, Rankin, A, Baker, D, Templeton, D, Jackson, E, Mccallum, K, Ryder, N, Sweeney, G, Carr, A, Macrae, K, Hesse, K, Finlayson, R, Gupta, S, Langton-Lockton, J, Shakeshaft, J, Brown, K, Idle, S, Arvela, N, Varma, R, Lu, H, Couldwell, D, Eswarappa, S, Furner, V, Cabrera, G, Fernando, S, Cogle, A, Lawrence, C, Mulhall, B, Boyd, M, Petoumenos, K, Puhr, R, Huang, R, Han, A, Gunathilake, M, Payne, R, O'Sullivan, M, Croydon, A, Russell, D, Cashman, C, Roberts, C, Sowden, D, Taing, K, Marshall, P, Orth, D, Youds, D, Rowling, D, Latch, N, Warzywoda, E, Dickson, B, Donohue, W, Edwards, S, Boyd, S, Roth, N, Lau, H, Read, T, Silvers, J, Zeng, W, Hoy, J, Watson, K, Bryant, M, Price, S, Woolley, I, Giles, M, Korman, T, Williams, J, Nolan, D, Allen, A, Guelfi, G, Mills, G, Wharry, C, Raymond, N, and Bargh, K

Subjects
Male, viruses, HIV Infections, Men who have sex with men, Cohort Studies, 0302 clinical medicine, Risk Factors, Antiretroviral therapy, Cohort study, HIV, Kaposi sarcoma, Adolescent, Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Female, HIV-1, Humans, Middle Aged, Sarcoma, Kaposi, Viral Load, Young Adult, 030212 general & internal medicine, Articles and Commentaries, Incidence (epidemiology), Hazard ratio, virus diseases, Sarcoma, 3. Good health, Infectious Diseases, 030220 oncology & carcinogenesis, Cohort, Coinfection, Microbiology (medical), antiretroviral therapy, 610 Medicine & health, Kaposi, 03 medical and health sciences, SDG 3 - Good Health and Well-being, 360 Social problems & social services, medicine, cohort study, business.industry, medicine.disease, Confidence interval, business, Demography
Abstract

Background We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. Methods We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). Results We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were

Published
2017

12. Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV.

Author

Han, WM, Jiamsakul, A, Jantarapakde, J, Yunihastuti, E, Choi, JY, Ditangco, R, Chaiwarith, R, Sun, LP, Khusuwan, S, Merati, TP, Do, CD, Azwa, I, Lee, M‐P, Van Nguyen, K, Chan, Y‐J, Kiertiburanakul, S, Ng, OT, Tanuma, J, Pujari, S, and Zhang, F

Subjects
CARDIOVASCULAR diseases risk factors, HIV-positive persons, HIV infections, OBESITY, CONFIDENCE intervals, CONVALESCENCE, IMMUNE system, REGRESSION analysis, TREATMENT effectiveness, HIGHLY active antiretroviral therapy, REPEATED measures design, DESCRIPTIVE statistics, BODY mass index, LONGITUDINAL method, PROPORTIONAL hazards models
Abstract

Objectives: We conducted a longitudinal cohort analysis to evaluate the association of pre‐treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV). Methods: Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated‐measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds. Results: Of 4993 PLHIV (66% male), 62% had pre‐treatment BMI in the normal range (18.5–25.0 kg/m2), while 26%, 10% and 2% were underweight (< 18.5 kg/m2), overweight (25–30 kg/m2) and obese (> 30 kg/m2), respectively. Both higher baseline and time‐updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23–27.5 and > 27.5 kg/m2 were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9–28.3] and 28.8 cells/µL (95% CI: 6.6–50.9), respectively, compared with normal BMI (18.5–23 kg/m2). PLHIV with BMIs of 25–30 and > 30 kg/m2 were 1.27 times (95% CI: 1.10–1.47) and 1.61 times (95% CI: 1.13–2.24) more likely to develop CVD risk factors. No relationship between pre‐treatment BMI and VF was observed. Conclusions: High pre‐treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort. [ABSTRACT FROM AUTHOR]

Published
2021
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13. Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific.

Author

Rupasinghe, D, Kiertiburanakul, S, Kamarulzaman, A, Zhang, F, Kumarasamy, N, Chaiwarith, R, Merati, TP, Do, CD, Khusuwan, S, Avihingsanon, A, Lee, MP, Ly, PS, Yunihastuti, E, Nguyen, KV, Ditangco, R, Chan, YJ, Pujari, S, Ng, OT, Choi, JY, and Sim, BLH

Subjects
HIV infection prognosis, MORTALITY risk factors, CONFIDENCE intervals, DATABASES, HIV infections, REGRESSION analysis, RISK assessment, SURVIVAL, ANTIRETROVIRAL agents, ALANINE aminotransferase, BODY mass index, IMMUNE reconstitution inflammatory syndrome, CD4 lymphocyte count, TREATMENT delay (Medicine), ODDS ratio
Abstract

Objectives: Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource‐limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia‐Pacific. Methods: PLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count < 100 cells/μL between 2003 and 2018 were included in the study. Early mortality was defined as death within 1 year of ART initiation. PLHIV in follow‐up for > 1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow‐up as a competing risk. Results: A total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first‐year mortality rate was 4.27 per 100 person‐years (PY). Thirty‐eight deaths (52%) were AIDS‐related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)‐related, 13 (18%) were non‐AIDS‐related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI) < 18.5 [sub‐hazard ratio (SHR) 2.91; 95% confidence interval (CI) 1.60–5.32] compared to BMI 18.5–24.9, and alanine aminotransferase (ALT) ≥ 5 times its upper limit of normal (ULN) (SHR 6.14; 95% CI 1.62–23.20) compared to ALT < 5 times its ULN. A higher CD4 count (51–100 cells/μL: SHR 0.28; 95% CI 0.14–0.55; and > 100 cells/μL: SHR 0.12; 95% CI 0.05–0.26) was associated with reduced hazard for mortality compared to CD4 count ≤ 25 cells/μL. Conclusions: Fifty‐two per cent of early deaths were AIDS‐related. Efforts to initiate ART at CD4 counts > 50 cell/μL are associated with improved short‐term survival rates, even in those with late stages of HIV disease. [ABSTRACT FROM AUTHOR]

Published
2020
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14. Adherence to antiretroviral therapy for HIV in sub-Saharan Africa and Asia: A comparative analysis of two regional cohorts

Author

Bijker, R, Jiamsakul, A, Kityo, C, Kiertiburanakul, S, Siwale, M, Phanuphak, P, Akanmu, S, Chaiwarith, R, Wit, FW, Sim, BLH, Boender, TS, Ditangco, R, De Wit, TFR, Sohn, AH, Hamers, RL, Bijker, R, Jiamsakul, A, Kityo, C, Kiertiburanakul, S, Siwale, M, Phanuphak, P, Akanmu, S, Chaiwarith, R, Wit, FW, Sim, BLH, Boender, TS, Ditangco, R, De Wit, TFR, Sohn, AH, and Hamers, RL

Abstract

Introduction: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia. Methods: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at followup clinic visits using a 30-day visual analogue scale. Determinants of suboptimal adherence (<95%) were assessed for sixmonth intervals, using generalized estimating equations multivariable logistic regression with multiple imputations. Region of residence (Africa vs. Asia) was assessed as a potential effect modifier. Results: Of 13,001 adherence assessments in 3934 participants during the first 24 months of ART, 6.4% (837) were suboptimal, with 7.3% (619/8484) in the African cohort versus 4.8% (218/4517) in the Asian cohort (p < 0.001). In the African cohort, determinants of suboptimal adherence were male sex (odds ratio (OR) 1.27, 95% confidence interval (CI) 1.06-1.53; p = 0.009), younger age (OR 0.8 per 10 year increase; 0.8-0.9; p = 0.003), use of concomitant medication (OR 1.8, 1.0-3.2; p = 0.044) and attending a public facility (OR 1.3, 95% CI 1.1-1.7; p = 0.004). In the Asian cohort, adherence was higher in men who have sex with men (OR for suboptimal adherence 0.6, 95% CI 0.4-0.9; p = 0.029) and lower in injecting drug users (OR for suboptimal adherence 1.6, 95% CI 0.9-2.6; p = 0.075), compared to heterosexuals. Risk of suboptimal adherence decreased with longer ART duration in both regions. Participants in low- and lower-middle-income countries had a higher risk of suboptimal adherence (OR 1.6, 1.3-2.0; p < 0.001), compared to those in upper-middle or high-income countries. Suboptimal adherence was strongly associated with virological failure, in Africa (OR 5.8, 95% CI 4.3-7.7; p < 0.

Published
2017

15. Factors associated with pre-treatment HIV RNA: Application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings

Author

Kiertiburanakul, S, Boettiger, D, Ng, OT, Kinh, N, Merati, TP, Avihingsanon, A, Wong, WW, Lee, MP, Chaiwarith, R, Kamarulzaman, A, Kantipong, P, Zhang, F, Choi, JY, Kumarasamy, N, Ditangco, R, Cuong, DD, Oka, S, Sim, BLH, Ratanasuwan, W, Ly, PS, Yunihastuti, E, Pujari, S, Ross, JL, Law, M, Sungkanuparph, S, Khol, V, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Saghayam, S, Ezhilarasi, C, Joshi, K, Gaikwad, S, Chitalikar, A, Wirawan, DN, Yuliana, F, Imran, D, Widhani, A, Tanuma, J, Nishijima, T, Na, S, Kim, JM, Gani, YM, David, R, Syed Omar, SF, Ponnampalavanar, S, Azwa, I, Uy, E, Bantique, R, Ku, WW, Wu, PC, Lim, PL, Lee, LS, Ohnmar, PS, Gatechompol, S, Phanuphak, P, Phadungphon, C, Chumla, L, Sanmeema, N, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kambua, P, Sriondee, R, Nguyen, KV, Bui, HV, Nguyen, DTH, Nguyen, DT, An, NV, Luan, NT, Sohn, AH, Petersen, B, Cooper, DA, Jiamsakul, A, Boettiger, DC, Kiertiburanakul, S, Boettiger, D, Ng, OT, Kinh, N, Merati, TP, Avihingsanon, A, Wong, WW, Lee, MP, Chaiwarith, R, Kamarulzaman, A, Kantipong, P, Zhang, F, Choi, JY, Kumarasamy, N, Ditangco, R, Cuong, DD, Oka, S, Sim, BLH, Ratanasuwan, W, Ly, PS, Yunihastuti, E, Pujari, S, Ross, JL, Law, M, Sungkanuparph, S, Khol, V, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Saghayam, S, Ezhilarasi, C, Joshi, K, Gaikwad, S, Chitalikar, A, Wirawan, DN, Yuliana, F, Imran, D, Widhani, A, Tanuma, J, Nishijima, T, Na, S, Kim, JM, Gani, YM, David, R, Syed Omar, SF, Ponnampalavanar, S, Azwa, I, Uy, E, Bantique, R, Ku, WW, Wu, PC, Lim, PL, Lee, LS, Ohnmar, PS, Gatechompol, S, Phanuphak, P, Phadungphon, C, Chumla, L, Sanmeema, N, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kambua, P, Sriondee, R, Nguyen, KV, Bui, HV, Nguyen, DTH, Nguyen, DT, An, NV, Luan, NT, Sohn, AH, Petersen, B, Cooper, DA, Jiamsakul, A, and Boettiger, DC

Abstract

© 2017 The Author(s). Background: Abacavir and rilpivirine are alternative antiretroviral drugs for treatment-naïve HIV-infected patients. However, both drugs are only recommended for the patients who have pre-treatment HIV RNA <100,000 copies/mL. In resource-limited settings, pre-treatment HIV RNA is not routinely performed and not widely available. The aims of this study are to determine factors associated with pre-treatment HIV RNA <100,000 copies/mL and to construct a model to predict this outcome. Methods: HIV-infected adults enrolled in the TREAT Asia HIV Observational Database were eligible if they had an HIV RNA measurement documented at the time of ART initiation. The dataset was randomly split into a derivation data set (75% of patients) and a validation data set (25%). Factors associated with pre-treatment HIV RNA <100,000 copies/mL were evaluated by logistic regression adjusted for study site. A prediction model and prediction scores were created. Results: A total of 2592 patients were enrolled for the analysis. Median [interquartile range (IQR)] age was 35.8 (29.9-42.5) years; CD4 count was 147 (50-248) cells/mm3; and pre-treatment HIV RNA was 100,000 (34,045-301,075) copies/mL. Factors associated with pre-treatment HIV RNA <100,000 copies/mL were age <30 years [OR 1.40 vs. 41-50 years; 95% confidence interval (CI) 1.10-1.80, p = 0.01], body mass index >30 kg/m2 (OR 2.4 vs. <18.5 kg/m2; 95% CI 1.1-5.1, p = 0.02), anemia (OR 1.70; 95% CI 1.40-2.10, p < 0.01), CD4 count >350 cells/mm3 (OR 3.9 vs. <100 cells/mm3; 95% CI 2.0-4.1, p < 0.01), total lymphocyte count >2000 cells/mm3 (OR 1.7 vs. <1000 cells/mm3; 95% CI 1.3-2.3, p < 0.01), and no prior AIDS-defining illness (OR 1.8; 95% CI 1.5-2.3, p < 0.01). Receiver-operator characteristic (ROC) analysis yielded area under the curve of 0.70 (95% CI 0.67-0.72) among derivation patients and 0.69 (95% CI 0.65-0.74) among validation patients. A cut off score >25 yielded the sensitivity of 46.7%, specificity of 79.1

Published
2017

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

Author

Jung, IY, Boettiger, D, Wong, WW, Lee, MP, Kiertiburanakul, S, Chaiwarith, R, Avihingsanon, A, Tanuma, J, Kumarasamy, N, Kamarulzaman, A, Zhang, F, Kantipong, P, Ng, OT, Sim, BLH, Law, M, Ross, J, Choi, JY, Jung, IY, Boettiger, D, Wong, WW, Lee, MP, Kiertiburanakul, S, Chaiwarith, R, Avihingsanon, A, Tanuma, J, Kumarasamy, N, Kamarulzaman, A, Zhang, F, Kantipong, P, Ng, OT, Sim, BLH, Law, M, Ross, J, and Choi, JY

Abstract

© 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society. Introduction: Although 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. Methods: The 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. Results: Of 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 t

Published
2017

17. Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ('Three I's') and HIV-Tuberculosis Service Integration in Lower Income Countries

Author

Charles, M.K., Lindegren, M.L., Wester, C.W., Blevins, M., Sterling, T.R., Dung, N.T., Dusingize, J.C., Avit-Edi, D., Durier, N., Castelnuovo, B., Nakigozi, G., Cortes, C.P., Ballif, M., Fenner, L., Ajayi, S., Anastos, K., Bashi, J., Bishai, W., Boulle, A., Braitstein, P., Carriquiry, G., Carter, J.E., Cegielski, P., Chimbetete, C., Davies, M.-A., Diero, L., Duda, S., Egger, M., Eboua, T.F., Gasser, A., Geng, E., Gnokori, J.C., Hardwicke, L., Hoffmann, C., Huebner, R., Kancheya, N., Kiertiburanakul, S., Kim, P., Lameck, D., Leroy, V., Lewden, C., Mandalakas, A., Maskew, M., McKaig, R., Mofenson, L., Mpoudi-Etame, M., Okwara, B., Phiri, S., Prasitsuebsai, W., Petit, A., Prozesky, H., Reid, S.E., Renner, L., Reubenson, G., Sohn, A., Vo, Q., Walker, D., Wehbe, F., Wejse, C., Williams, C., Wood, R., Wools-Kaloustian, K., Yao, Z., Yunihastuti, E., Zhang, F.J., Zhao, H.X., Han, N., Merati, T.P., Wirawan, D.N., Yuliana, F., Ditangco, R., Uy, E., Bantique, R., Phanuphak, P., Ruxrungtham, K., Avihingsanon, A., Khongphattanayothin, M., Sungkanuparph, S., Sanmeema, N., Chaiwarith, R., Sirisanthana, T., Kotarathititum, W., Pham, T.T., Cuong, D.D., Ha, H.L., Nguyen, V.K., Bui, V.H., Nguyen, T.D., Sohn, A.H., Petersen, B., Cooper, D.A., Law, M.G., Jiamsakul, A., Boettiger, D.C., Wati, D.K., Atmikasari, L.P.P., Malino, I.Y., Nallusamy, R., Chan, K.C., Lumbiganon, P., Kosalaraksa, P., Tharnprisan, P., Udomphanit, T., Phongsamart, W., Wittawatmongkol, O., Dung, K.T.K., Lam, N.V., An, P.N., Loan, N.T., Truong, H.K., Du, T.Q., Chau, N.H., Do, C.V., Ha, M.T., Nipathakosol, P., Kariminia, A., Mutimura, E., Gitembagara, A., Tatwangire, J., Izabelle, I., Niyongabo, T., Twizere, C., Baramperanye, E., Edmonds, A., Yotebieng, M., Azinyue, I., Ayangma, L., Dickinson, D., Eley, B., Fritz, C., Garone, D., Giddy, J., MacPhail, P., Moultrie, H., Ndirangu, J., Pestilli, S., Rabie, H., Stringer, J., Technau, K., Graber, C., Kaeser, F., Keiser, O., Cornell, M., Maxwell, N., Zannou, D.M., Ahouada, C., Akakpo, J., Ahomadegbé, C., Gougounon-Houéto, A., Azon-Kouanou, A., Houngbé, F., Sehonou, J., Koumakpaï, S., Alihonou, F., D'Almeida, M., Hodonou, I., Hounhoui, G., Sagbo, G., Tossa-Bagnan, L., Adjide, H., Drabo, J., Bognounou, R., Dienderé, A., Traore, E., Zoungrana, L., Zerbo, B., Sawadogo, A.B., Zoungrana, J., Héma, A., Soré, I., Bado, G., Tapsoba, A., Yé, D., Kouéta, F., Ouedraogo, S., Ouédraogo, R., Hiembo, W., Gansonré, M., Messou, E., Gnokoro, J.C., Koné, M., Kouakou, G.M., Bosse, C.A., Brou, K., Assi, A.I., Chenal, H., Hawerlander, D., Soppi, F., Minga, A., Abo, Y., Yoboue, J.-M., Eholié, S.P., Amego, M.D.N., Andavi, V., Diallo, Z., Ello, F., Tanon, A.K., Koule, S.O., Anzan, K.C., Guehi, C., Aka, E.A., Issouf, K.L., Kouakou, J.-C., N'Gbeche, M.-S., Pety, T., Kouakou, K., Moh, M., Yao, V.A., Folquet, M.A., Dainguy, M.-E., Kouakou, C., Méa-Assande, V.T., Oka-Berete, G., Zobo, N., Acquah, P., Kokora, M.-B., Timité-Konan, M., Ahoussou, L.D., Assouan, J.K., Sami, M.F., Kouadio, C., Goka, B., Welbeck, J., Sackey, A., Owiafe, S.N., Da Silva, Z.J., Paulo, J., Rodrigues, A., Da Silva, D., Medina, C., Oliviera-Souto, I., Østergaard, L., Laursen, A., Sodemann, M., Aaby, P., Fomsgaard, A., Erikstrup, C., Eugen-Olsen, J., Maïga, M.Y., Diakité, F.F., Kalle, A., Katile, D., Traore, H.A., Minta, D., Cissé, T., Dembelé, M., Doumbia, M., Fomba, M., Kaya, A.S., Traoré, A.M., Traoré, H., Toure, A.A., Dicko, F., Sylla, M., Berthé, A., Traoré, H.C., Koïta, A., Koné, N., N'Diaye, C., Coulibaly, S.T., Traoré, M., Traoré, N., Charurat, M., Alim, G., Dapiap, S., Otu, Igbinoba, F., Benson, O., Adebamowo, C., James, J., Obaseki, Osakede, P., Olasode, J., Seydi, M., Sow, P.S., Diop, B., Manga, N.M., Tine, J.M., Bassabi, C.C., Sy, H.S., Ba, A., Diagne, A., Dior, H., Faye, M., Gueye, R.D., Mbaye, A.D., Patassi, A., Kotosso, A., Kariyare, B.G., Gbadamassi, G., Komi, A., Mensah-Zukong, K.E., Pakpame, P., Lawson-Evi, A.K., Atakouma, Y., Takassi, E., Djeha, A., Ephoévigah, A., Djibril, S.E.-H., Dabis, F., Bissagnene, E., Arrivé, E., Coffie, P., Ekouevi, D., Jaquet, A., Sasco, A.J., Amani, D., Azani, J.-C., Balestre, E., Bessekon, S., Bohossou, F., Gilbert, C., Karcher, S., Gonsan, J.M., Le Carrou, J., Lenaud, S., Nchot, C., Malateste, K., Yao, A.R., Siloué, B., Clouet, G., Dosso, M., Doring, A., Kouakou, A., Rabourdin, E., Rivenc, J., Anglaret, X., Ba, B., Essanin, J.B., Ciaranello, A., Datté, S., Desmonde, S., Diby, J.-S.E., Gottlieb, G.S., Horo, A.G., Kangah, S.N., Malvy, D., Meless, D., Mounkaila-Harouna, A., Ndondoki, C., Shiboski, C., Tchounga, B., Thiébaut, R., Wandeler, G., McGowan, C., Cahn, P., Gotuzzo Herencia, José Eduardo, Reyes, M.W., Grinsztejn, B., Pape, J.W., Padgett, D., and Madero, J.S.

Subjects
0301 basic medicine, Program evaluation, Bacterial Diseases, poverty, Physiology, Antitubercular Agents, lcsh:Medicine, HIV Infections, Pathology and Laboratory Medicine, Occupational safety and health, Geographical Locations, 0302 clinical medicine, case finding, Health care, lowest income group, Medicine and Health Sciences, Coughing, Medicine, Infection control, 030212 general & internal medicine, lcsh:Science, fever, Multidisciplinary, antiretrovirus agent, adult, HIV diagnosis and management, sputum smear, Vaccination and Immunization, 3. Good health, Infectious Diseases, Caribbean Region, Tuberculosis Diagnosis and Management, protective equipment, tuberculosis control, Research Article, medicine.medical_specialty, isoniazid, Tuberculosis, Asia, integrated health care system, 030106 microbiology, HIV prevention, Immunology, Developing country, Antiretroviral Therapy, complication, 610 Medicine & health, World Health Organization, Article, 03 medical and health sciences, Signs and Symptoms, Tuberculosis diagnosis, Antiviral Therapy, Human immunodeficiency virus infection, night sweat, 360 Social problems & social services, Environmental health, parasitic diseases, Isoniazid, Humans, purl.org/pe-repo/ocde/ford#3.01.05 [https], human, coughing, Poverty, tuberculin test, Caribbean, Preventive medicine, Infection Control, AIDS-Related Opportunistic Infections, business.industry, screening, lcsh:R, Biology and Life Sciences, occupational safety, South America, medicine.disease, Tropical Diseases, Diagnostic medicine, mask, Public and occupational health, purl.org/pe-repo/ocde/ford#3.02.07 [https], People and Places, Africa, Physical therapy, tuberculostatic agent, lcsh:Q, weight reduction, business, Physiological Processes
Abstract

SETTING World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. OBJECTIVE To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. DESIGN Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. RESULTS ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% non-integrated; p = 0.03). CONCLUSIONS Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.

Published
2016

18. Long‐term loss to follow‐up in the TREAT Asia HIV Observational Database (TAHOD).

Author

Jiamsakul, A, Kiertiburanakul, S, Ng, OT, Chaiwarith, R, Wong, W, Ditangco, R, Nguyen, KV, Avihingsanon, A, Pujari, S, Do, CD, Lee, M‐P, Ly, PS, Yunihastuti, E, Kumarasamy, N, Kamarulzaman, A, Tanuma, J, Zhang, F, Choi, JY, Kantipong, P, and Sim, BLH

Subjects
ANTIRETROVIRAL agents, AGE distribution, COMPARATIVE studies, CONFIDENCE intervals, HEPATITIS C, HIV infections, HIV-positive persons, PATIENT aftercare, PATIENT compliance, REGRESSION analysis, SEX distribution, TIME, VIRAL load, SOCIOECONOMIC factors, DESCRIPTIVE statistics, CD4 lymphocyte count, MIXED infections
Abstract

Objectives: With earlier antiretroviral therapy (ART) initiation, time spent in HIV care is expected to increase. We aimed to investigate loss to follow‐up (LTFU) in Asian patients who remained in care 5 years after ART initiation. Methods: Long‐term LTFU was defined as LTFU occurring after 5 years on ART. LTFU was defined as (1) patients not seen in the previous 12 months; and (2) patients not seen in the previous 6 months. Factors associated with LTFU were analysed using competing risk regression. Results: Under the 12‐month definition, the LTFU rate was 2.0 per 100 person‐years (PY) [95% confidence interval (CI) 1.8–2.2 among 4889 patients included in the study. LTFU was associated with age > 50 years [sub‐hazard ratio (SHR) 1.64; 95% CI 1.17–2.31] compared with 31–40 years, viral load ≥ 1000 copies/mL (SHR 1.86; 95% CI 1.16–2.97) compared with viral load < 1000 copies/mL, and hepatitis C coinfection (SHR 1.48; 95% CI 1.06–2.05). LTFU was less likely to occur in females, in individuals with higher CD4 counts, in those with self‐reported adherence ≥ 95%, and in those living in high‐income countries. The 6‐month LTFU definition produced an incidence rate of 3.2 per 100 PY (95% CI 2.9–3.4 and had similar associations but with greater risks of LTFU for ART initiation in later years (2006–2009: SHR 2.38; 95% CI 1.93–2.94; and 2010–2011: SHR 4.26; 95% CI 3.17–5.73) compared with 2003–2005. Conclusions: The long‐term LTFU rate in our cohort was low, with older age being associated with LTFU. The increased risk of LTFU with later years of ART initiation in the 6‐month analysis, but not the 12‐month analysis, implies that there was a possible move towards longer HIV clinic scheduling in Asia. [ABSTRACT FROM AUTHOR]

Published
2019
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19. Cardiovascular disease‐related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database (TAHOD).

Author

Bijker, R, Jiamsakul, A, Uy, E, Kumarasamy, N, Ditango, R, Chaiwarith, R, Wong, WW, Avihingsanon, A, Sun, LP, Yunihastuti, E, Pujari, S, Do, CD, Merati, TP, Kantipong, P, Nguyen, KV, Kamarulzaman, A, Zhang, F, Lee, MP, Choi, JY, and Tanuma, J

Subjects
CARDIOVASCULAR disease diagnosis, CARDIOVASCULAR disease related mortality, HIV infection complications, ANTIRETROVIRAL agents, CARDIOVASCULAR diseases risk factors, CHOLESTEROL, CONFIDENCE intervals, HIV infections, HYPERTENSION, LONGITUDINAL method, SCIENTIFIC observation, REGRESSION analysis, RISK assessment, TRIGLYCERIDES, BODY mass index, DISEASE incidence, MIDDLE-income countries, LOW-income countries, ODDS ratio
Abstract

Objectives: With aging of the HIV‐positive population, cardiovascular disease (CVD) increasingly contributes to morbidity and mortality. We investigated CVD‐related and other causes of death (CODs) and factors associated with CVD in a multi‐country Asian HIV‐positive cohort. Methods: Patient data from 2003–2017 were obtained from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD). We included patients on antiretroviral therapy (ART) with > 1 day of follow‐up. Cumulative incidences were plotted for CVD‐related, AIDS‐related, non‐AIDS‐related, and unknown CODs, and any CVD (i.e. fatal and nonfatal). Competing risk regression was used to assess risk factors of any CVD. Results: Of 8069 patients with a median follow‐up of 7.3 years [interquartile range (IQR) 4.4–10.7 years], 378 patients died [incidence rate (IR) 6.2 per 1000 person‐years (PY)], and this total included 22 CVD‐related deaths (IR 0.36 per 1000 PY). Factors significantly associated with any CVD event (IR 2.2 per 1000 PY) were older age [sub‐hazard ratio (sHR) 2.21; 95% confidence interval (CI) 1.36–3.58 for age 41–50 years; sHR 5.52; 95% CI 3.43–8.91 for ≥ 51 years, compared with < 40 years], high blood pressure (sHR 1.62; 95% CI 1.04–2.52), high total cholesterol (sHR 1.89; 95% CI 1.27–2.82), high triglycerides (sHR 1.55; 95% CI 1.02–2.37) and high body mass index (BMI) (sHR 1.66; 95% CI 1.12–2.46). CVD crude IRs were lower in the later ART initiation period and in lower middle‐ and upper middle‐income countries. Conclusions: The development of fatal and nonfatal CVD events in our cohort was associated with older age, and treatable risk factors such as high blood pressure, triglycerides, total cholesterol and BMI. Lower CVD event rates in middle‐income countries may indicate under‐diagnosis of CVD in Asian‐Pacific resource‐limited settings. [ABSTRACT FROM AUTHOR]

Published
2019
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20. Hepatitis B and C co-infection in HIV patients from the TREAT Asia HIV observational database: Analysis of risk factors and survival

Author

Chen, M, Wong, WW, Law, MG, Kiertiburanakul, S, Yunihastuti, E, Merati, TP, Lim, PL, Chaiwarith, R, Phanuphak, P, Lee, MP, Kumarasamy, N, Saphonn, V, Ditangco, R, Sim, BLH, Van Nguyen, K, Pujari, S, Kamarulzaman, A, Zhang, F, Pham, TT, Choi, JY, Oka, S, Kantipong, P, Mustafa, M, Ratanasuwan, W, Durier, N, Chen, YMA, Chen, M, Wong, WW, Law, MG, Kiertiburanakul, S, Yunihastuti, E, Merati, TP, Lim, PL, Chaiwarith, R, Phanuphak, P, Lee, MP, Kumarasamy, N, Saphonn, V, Ditangco, R, Sim, BLH, Van Nguyen, K, Pujari, S, Kamarulzaman, A, Zhang, F, Pham, TT, Choi, JY, Oka, S, Kantipong, P, Mustafa, M, Ratanasuwan, W, Durier, N, and Chen, YMA

Abstract

Background We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region. Methods Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/orHCV co-infection were assessed by logistic regression models. Factors associated with post-ART HIV immunological response (CD4 change after six months) and virological response (HIV RNA <400 copies/ml after 12 months) were also determined. Survival was assessed by the Kaplan-Meier method and log rank test. Results A total of 7,455 subjects were recruited by December 2012. Of patients tested, 591/5656 (10.4%) were HBsAg positive, 794/5215 (15.2%) were HCVAb positive, and 88/4966 (1.8%) were positive for both markers. In multivariate analysis, HCV co-infection, age, route of HIV infection, baseline CD4 count, baseline HIV RNA, and HIV-1 subtype were associated with immunological recovery. Age, route of HIV infection, baseline CD4 count, baseline HIV RNA, ART regimen, prior ART and HIV-1 subtype, but not HBV or HCV co-infection, affected HIV RNA suppression. Risk factors affecting mortality included HCV co-infection, age, CDC stage, baseline CD4 count, baseline HIV RNA and prior mono/dual ART. Shortest survival was seen in subjects who were both HBV-and HCV-positive. Conclusion In this Asian cohort of HIV-infected patients, HCV co-infection, but not HBV co-infection, was associated with lower CD4 cell recovery after ART and increased mortality.

Published
2016

21. Tenofovir-based antiretroviral therapy in HBV-HIV coinfection: Results from the treat Asia HIV Observational Database

Author

Boettiger, DC, Kerr, S, Ditangco, R, Chaiwarith, R, Li, PCK, Merati, TP, Pham, TTT, Kiertiburanakul, S, Kumarasamy, N, Vonthanak, S, Lee, CKC, Van Kinh, N, Pujari, S, Wong, WW, Kamarulzaman, A, Zhang, F, Yunihastuti, E, Choi, JY, Oka, S, Ng, OT, Kantipong, P, Mustafa, M, Ratanasuwan, W, Durier, N, Law, M, Boettiger, DC, Kerr, S, Ditangco, R, Chaiwarith, R, Li, PCK, Merati, TP, Pham, TTT, Kiertiburanakul, S, Kumarasamy, N, Vonthanak, S, Lee, CKC, Van Kinh, N, Pujari, S, Wong, WW, Kamarulzaman, A, Zhang, F, Yunihastuti, E, Choi, JY, Oka, S, Ng, OT, Kantipong, P, Mustafa, M, Ratanasuwan, W, Durier, N, and Law, M

Abstract

Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe irst-line tenofovir use and treatment outcomes in coinfected patients in Asia. Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started irst-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use. Generalized estimating equations were used to evaluate factors associated with alanine transaminase levels and CD4+ T-cell count on treatment. Results: There were 548 eligible patients, of whom 149 (27.2%) started tenofovir. Patients treated in high/highmiddle income countries (odds ratio 4.4 versus low/lowmiddle, 95% CI 2.6, 7.4; P<0.001) and those with elevated baseline alanine transaminase (odds ratio 4.2 versus normal, 95% CI 2.4, 7.2; P<0.001) were more likely to receive tenofovir. Hepatitis C antibody positive patients (odds ratio 0.4 versus negative, 95% CI 0.2, 0.8; P=0.008) were less likely. In those starting antiretroviral therapy with elevated alanine transaminase, mean reduction after tenofovir initiation was 11.2 IU/l (95% CI 0.9, 21.6; P=0.034) lower compared with those using a non-tenofovir-based regimen although this did not signiicantly increase the chance of alanine transaminase normalization. Tenofovir use was not associated with a superior CD4+ T-cell response. Conclusions: HBV-HIV-coinfected patients in Asia are most likely to receive tenofovir if they are treated in a high/highmiddle income country, have elevated alanine transaminase levels and are hepatitis C antibody negative. Compared to other antiretroviral therapies, tenofovir-based regimens more effectively reduce liver inlammation in HBV-HIV-coinfection but do not result in superior CD4+ T-cell recovery.

Published
2016

22. Renal dysfunction during tenofovir use in a regional cohort of HIV-infected individuals in the Asia-Pacific

Author

Tanuma, J, Jiamsakul, A, Makane, A, Avihingsanon, A, Ng, OT, Kiertiburanakul, S, Chaiwarith, R, Kumarasamy, N, Van Nguyen, K, Pham, TT, Lee, MP, Ditangco, R, Merati, TP, Choi, JY, Wong, WW, Kamarulzaman, A, Yunihastuti, E, Sim, BL, Ratanasuwan, W, Kantipong, P, Zhang, F, Mustafa, M, Saphonn, V, Pujari, S, Sohn, AH, Mean, CV, Vohith, K, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Wong, KH, Saghayam, S, Ezhilarasi, C, Joshi, K, Wirawan, DN, Yuliana, F, Imran, D, Widhani, A, Oka, S, Nishijima, T, Na, S, Kim, JM, Gani, YM, David, R, Omar, SFS, Ponnampalavanar, S, Azwa, I, Huda, N, Ong, LY, Uy, E, Bantique, R, Ku, WW, Wu, PC, Lim, PL, Lee, LS, Ohnmar, PS, Phanuphak, P, Ruxrungtham, K, Chusut, P, Sirivichayakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kambua, P, Sriondee, R, Bui, VH, Cao, TT, Cuong, DD, Ha, HL, Durier, N, Petersen, B, Singtoroj, T, Cooper, DA, Law, MG, Boettiger, DC, Tanuma, J, Jiamsakul, A, Makane, A, Avihingsanon, A, Ng, OT, Kiertiburanakul, S, Chaiwarith, R, Kumarasamy, N, Van Nguyen, K, Pham, TT, Lee, MP, Ditangco, R, Merati, TP, Choi, JY, Wong, WW, Kamarulzaman, A, Yunihastuti, E, Sim, BL, Ratanasuwan, W, Kantipong, P, Zhang, F, Mustafa, M, Saphonn, V, Pujari, S, Sohn, AH, Mean, CV, Vohith, K, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Wong, KH, Saghayam, S, Ezhilarasi, C, Joshi, K, Wirawan, DN, Yuliana, F, Imran, D, Widhani, A, Oka, S, Nishijima, T, Na, S, Kim, JM, Gani, YM, David, R, Omar, SFS, Ponnampalavanar, S, Azwa, I, Huda, N, Ong, LY, Uy, E, Bantique, R, Ku, WW, Wu, PC, Lim, PL, Lee, LS, Ohnmar, PS, Phanuphak, P, Ruxrungtham, K, Chusut, P, Sirivichayakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kambua, P, Sriondee, R, Bui, VH, Cao, TT, Cuong, DD, Ha, HL, Durier, N, Petersen, B, Singtoroj, T, Cooper, DA, Law, MG, and Boettiger, DC

Abstract

Background: In resource-limited settings, routine monitoring of renal function during antiretroviral therapy (ART) has not been recommended. However, concerns for tenofovir disoproxil fumarate (TDF)-related nephrotoxicity persist with increased use. Methods: We investigated serum creatinine (S-Cr) monitoring rates before and during ART and the incidence and prevalence of renal dysfunction after starting TDF by using data from a regional cohort of HIV-infected individuals in the Asia-Pacific. Time to renal dysfunction was defined as time from TDF initiation to the decline in estimated glomerular filtration rate (eGFR) to <60 ml/min/1.73m2 with >30% reduction from baseline using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation or the decision to stop TDF for reported TDF-nephrotoxicity. Predictors of S-Cr monitoring rates were assessed by Poisson regression and risk factors for developing renal dysfunction were assessed by Cox regression. Results: Among 2,425 patients who received TDF, S-Cr monitoring rates increased from 1.01 to 1.84 per person per year after starting TDF (incidence rate ratio 1.68, 95%CI 1.62-1.74, p <0.001). Renal dysfunction on TDF occurred in 103 patients over 5,368 person-years of TDF use (4.2%; incidence 1.75 per 100 person-years). Risk factors for developing renal dysfunction included older age (>50 vs. ≤30, hazard ratio [HR] 5.39, 95%CI 2.52-11.50, p <0.001; and using PI-based regimen (HR 1.93, 95%CI 1.22-3.07, p = 0.005). Having an eGFR prior to TDF (pre-TDF eGFR) of ≥60 ml/min/1.73m2 showed a protective effect (HR 0.38, 95%CI, 0.17-0.85, p = 0.018). Conclusions: Renal dysfunction on commencing TDF use was not common, however, older age, lower baseline eGFR and PI-based ART were associated with higher risk of renal dysfunction during TDF use in adult HIV-infected individuals in the Asia-Pacific region.

Published
2016

23. Incidence of syphilis seroconversion among HIV-infected persons in Asia: Results from the TREAT Asia HIV Observational Database

Author

Ahn, JY, Boettiger, D, Kiertiburanakul, S, Merati, TP, Huy, BV, Wong, WW, Ditangco, R, Lee, MP, Oka, S, Durier, N, Choi, JY, Mean, CV, Saphonn, V, Vohith, K, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Wirawan, DN, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Nishijima, T, Na, S, Kim, JM, Sim, BLH, Gani, YM, David, R, Kamarulzaman, A, Syed Omar, SF, Ponnampalavanar, S, Azwa, I, Uy, E, Bantique, R, Ku, WW, Wu, PC, Ng, OT, Lim, PL, Lee, LS, Ohnmar, PS, Phanuphak, P, Ruxrungtham, K, Avihingsanon, A, Chusut, P, Sirivichayakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, VK, Bui, VH, Nguyen, THD, Pham, TT, Cuong, DD, Ha, HL, Sohn, AH, Petersen, B, Cooper, DA, Law, MG, Jiamsakul, A, Ahn, JY, Boettiger, D, Kiertiburanakul, S, Merati, TP, Huy, BV, Wong, WW, Ditangco, R, Lee, MP, Oka, S, Durier, N, Choi, JY, Mean, CV, Saphonn, V, Vohith, K, Zhang, FJ, Zhao, HX, Han, N, Li, PCK, Lam, W, Chan, YT, Kumarasamy, N, Saghayam, S, Ezhilarasi, C, Pujari, S, Joshi, K, Gaikwad, S, Chitalikar, A, Wirawan, DN, Yuliana, F, Yunihastuti, E, Imran, D, Widhani, A, Tanuma, J, Nishijima, T, Na, S, Kim, JM, Sim, BLH, Gani, YM, David, R, Kamarulzaman, A, Syed Omar, SF, Ponnampalavanar, S, Azwa, I, Uy, E, Bantique, R, Ku, WW, Wu, PC, Ng, OT, Lim, PL, Lee, LS, Ohnmar, PS, Phanuphak, P, Ruxrungtham, K, Avihingsanon, A, Chusut, P, Sirivichayakul, S, Sungkanuparph, S, Chumla, L, Sanmeema, N, Chaiwarith, R, Sirisanthana, T, Kotarathititum, W, Praparattanapan, J, Kantipong, P, Kambua, P, Ratanasuwan, W, Sriondee, R, Nguyen, VK, Bui, VH, Nguyen, THD, Pham, TT, Cuong, DD, Ha, HL, Sohn, AH, Petersen, B, Cooper, DA, Law, MG, and Jiamsakul, A

Abstract

Introduction: Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Methods: Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. Results: We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY). Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, p<0.001). Among MSM, the incidence rate ratio (IRR) for every additional year from 2009 was 1.19 (p=0.051). MSM status (IRR 3.48, 95% confidence interval (CI) 1.88-6.47), past syphilis diagnosis (IRR 5.15, 95% CI 3.69-7.17) and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706-0.997) were significantly associated with syphilis seroconversion. Conclusions: We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population.

Published
2016

24. Results from the Survey of Antibiotic Resistance (SOAR) 2012–14 in Thailand, India, South Korea and Singapore

Author

Torumkuney, D., primary, Chaiwarith, R., primary, Reechaipichitkul, W., primary, Malatham, K., primary, Chareonphaibul, V., primary, Rodrigues, C., primary, Chitkins, D. S., primary, Dias, M., primary, Anandan, S., primary, Kanakapura, S., primary, Park, Y. J., primary, Lee, K., primary, Lee, H., primary, Kim, J. Y., primary, Lee, Y., primary, Lee, H. K., primary, Kim, J. H., primary, Tan, T. Y., primary, Heng, Y. X., primary, Mukherjee, P., primary, and Morrissey, I., primary

Published
2016
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25. The occurrence of Simpson's paradox if site-level effect was ignored in the TREAT Asia HIV Observational Database

Author

Jiamsakul, Awachana, primary, Kerr, Stephen J., additional, Chandrasekaran, Ezhilarasi, additional, Huelgas, Aizobelle, additional, Taecharoenkul, Sineenart, additional, Teeraananchai, Sirinya, additional, Wan, Gang, additional, Ly, Penh Sun, additional, Kiertiburanakul, Sasisopin, additional, Law, Matthew, additional, Ly, P.S., additional, Khol, V., additional, Zhang, F.J., additional, Zhao, H.X., additional, Han, N., additional, Lee, M.P., additional, Li, P.C.K., additional, Lam, W., additional, Chan, Y.T., additional, Kumarasamy, N., additional, Saghayam, S., additional, Ezhilarasi, C., additional, Pujari, S., additional, Joshi, K., additional, Gaikwad, S., additional, Chitalikar, A., additional, Merati, T.P., additional, Wirawan, D.N., additional, Yuliana, F., additional, Yunihastuti, E., additional, Imran, D., additional, Widhani, A., additional, Oka, S., additional, Tanuma, J., additional, Nishijima, T., additional, Choi, J.Y., additional, Na, S., additional, Kim, J.M., additional, Sim, B.L.H., additional, Gani, Y.M., additional, David, R., additional, Kamarulzaman, A., additional, Syed Omar, S.F., additional, Ponnampalavanar, S., additional, Azwa, I., additional, Mustafa, M., additional, Nordin, N., additional, Ditangco, R., additional, Uy, E., additional, Bantique, R., additional, Wong, W.W., additional, Ku, W.W., additional, Wu, P.C., additional, Ng, O.T., additional, Lim, P.L., additional, Lee, L.S., additional, Martinez-Vega, R., additional, Phanuphak, P., additional, Ruxrungtham, K., additional, Avihingsanon, A., additional, Chusut, P., additional, Kiertiburanakul, S., additional, Sungkanuparph, S., additional, Chumla, L., additional, Sanmeema, N., additional, Chaiwarith, R., additional, Sirisanthana, T., additional, Kotarathititum, W., additional, Praparattanapan, J., additional, Kantipong, P., additional, Kambua, P., additional, Ratanasuwan, W., additional, Sriondee, R., additional, Nguyen, K.V., additional, Bui, V.H., additional, Nguyen, D.T.H., additional, Nguyen, D.T., additional, Pham, T.T., additional, Cuong, D.D., additional, Ha, H.L., additional, Sohn, A.H., additional, Durier, N., additional, Petersen, B., additional, Cooper, D.A., additional, Law, M.G., additional, Jiamsakul, A., additional, and Boettiger, D.C., additional

Published
2016
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26. Smoking and projected cardiovascular risk in an HIV-positive Asian regional cohort

Author

Do, TC, primary, Boettiger, D, additional, Law, M, additional, Pujari, S, additional, Zhang, F, additional, Chaiwarith, R, additional, Kiertiburanakul, S, additional, Lee, MP, additional, Ditangco, R, additional, Wong, WW, additional, Nguyen, KV, additional, Merati, TP, additional, Pham, TT, additional, Kamarulzaman, A, additional, Oka, S, additional, Yunihastuti, E, additional, Kumarasamy, N, additional, Kantipong, P, additional, Choi, JY, additional, Ng, OT, additional, Durier, N, additional, and Ruxrungtham, K, additional

Published
2016
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27. Effects of CD4 Monitoring Frequency on Clinical End Points in Clinically Stable HIV-Infected Patients with Viral Suppression

Author

Ahn, JY, Boettiger, D, Law, M, Kumarasamy, N, Yunihastuti, E, Chaiwarith, R, Lee, MP, Sim, BLH, Oka, S, Wong, W, Kamarulzaman, A, Kantipong, P, Phanuphak, P, Ng, OT, Kiertiburanakul, S, Zhang, F, Pujari, S, Ditangco, R, Ratanasuwan, W, Merati, TP, Saphonn, V, Sohn, AH, Choi, JY, Ahn, JY, Boettiger, D, Law, M, Kumarasamy, N, Yunihastuti, E, Chaiwarith, R, Lee, MP, Sim, BLH, Oka, S, Wong, W, Kamarulzaman, A, Kantipong, P, Phanuphak, P, Ng, OT, Kiertiburanakul, S, Zhang, F, Pujari, S, Ditangco, R, Ratanasuwan, W, Merati, TP, Saphonn, V, Sohn, AH, and Choi, JY

Abstract

Background: Current treatment guidelines for HIV infection recommend routine CD4+ lymphocyte (CD4) count monitoring in patients with viral suppression. This may have a limited impact on influencing care as clinically meaningful CD4 decline rarely occurs during viral suppression. Methods: In a regional HIV observational cohort in the Asia-Pacific region, patients with viral suppression (2 consecutive viral loads <400 copies/mL) and a CD4 count ≥200 cells per microliter who had CD4 testing 6 monthly were analyzed. Main study end points were occurrence of 1 CD4 count <200 cells per microliter (single CD4 <200) and 2 CD4 counts <200 cells per microliter within a 6-month period (confirmed CD4 <200). A comparison of time with single and confirmed CD4 <200 with biannual or annual CD4 assessment was performed by generating a hypothetical group comprising the same patients with annual CD4 testing by removing every second CD4 count. Results: Among 1538 patients, the rate of single CD4 <200 was 3.45/100 patient-years and of confirmed CD4 <200 was 0.77/100 patient-years. During 5 years of viral suppression, patients with baseline CD4 200-249 cells per microliter were significantly more likely to experience confirmed CD4 <200 compared with patients with higher baseline CD4 [hazard ratio, 55.47 (95% confidence interval: 7.36 to 418.20), P < 0.001 versus baseline CD4 ≥500 cells/μL]. Cumulative probabilities of confirmed CD4 <200 was also higher in patients with baseline CD4 200-249 cells per microliter compared with patients with higher baseline CD4. There was no significant difference in time to confirmed CD4 <200 between biannual and annual CD4 measurement (P = 0.336). Conclusions: Annual CD4 monitoring in virally suppressed HIV patients with a baseline CD4 ≥250 cells per microliter may be sufficient for clinical management.

Published
2015

28. HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD).

Author

Lawrence C., Silvers J., Zeng W., Watson K., Bryant M., Price S., Woolley I., Korman T., Williams J., Nolan D., Skett J., Robinson J., Mean C.V., Saphonn V., Vohith K., Zhang F.J., Li P.C.K., Lee M.P., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Makane A., Merati T.P., Wirawan D.N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Oka S., Tanuma J., Nishijima T., Choi J.Y., Na S., Kim J.M., Lee C.K.C., Sim B.L.H., David R., Syed Omar S.F., Azwa I., Ditangco R., Uy E., Bantique R., Wong W.W., Ku W.W., Wu P.C., Ng O.T., Lim P.L., Lee L.S., Tan M.T., Phanuphak P., Ruxrungtham K., Avihingsanon A., Chusut P., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen V.K., Bui V.H., Cao T.T., Pham T.T., Cuong D.D., Ha H.L., Sohn A.H., Durier N., Petersen B., Jiamsakul A., Boettiger D., Kelly M., Gibson A., Magon H., Donohue W., Moore R., Edwards S., Han N., Wright S.T., O'Connor C.C., Hoy J., Ponnampalavanar S., Grotowski M., Zhao H.X., Kamarulzaman A., Ellis D., Bloch M., Franic T., Agrawal S., McCann L., Cunningham N., Vincent T., Allen D., Little J.L., Smith D., Gray C., Baker D., Vale R., Templeton D.J., Dijanosic C., Jackson E., McCallum K., Taylor S., Cooper D.A., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Shakeshaft J., Brown K., McGrath C., McGrath V., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Watson J., Giles M., Mulhall B., Law M., Petoumenos K., McManus H., Bendall C., Boyd M., Kulatunga A., Knibbs P., Chuah J., Ngieng M., Dickson B., Russell D., Downing S., Sowden D., Broom J., Taing K., Johnston C., McGill K., Orth D., Youds D., Liddle R., Locke P., Roth N.J., Nicolson J., Lau H., Read T., Lawrence C., Silvers J., Zeng W., Watson K., Bryant M., Price S., Woolley I., Korman T., Williams J., Nolan D., Skett J., Robinson J., Mean C.V., Saphonn V., Vohith K., Zhang F.J., Li P.C.K., Lee M.P., Kumarasamy N., Saghayam S., Ezhilarasi C., Pujari S., Joshi K., Makane A., Merati T.P., Wirawan D.N., Yuliana F., Yunihastuti E., Imran D., Widhani A., Oka S., Tanuma J., Nishijima T., Choi J.Y., Na S., Kim J.M., Lee C.K.C., Sim B.L.H., David R., Syed Omar S.F., Azwa I., Ditangco R., Uy E., Bantique R., Wong W.W., Ku W.W., Wu P.C., Ng O.T., Lim P.L., Lee L.S., Tan M.T., Phanuphak P., Ruxrungtham K., Avihingsanon A., Chusut P., Kiertiburanakul S., Sungkanuparph S., Chumla L., Sanmeema N., Chaiwarith R., Sirisanthana T., Kotarathititum W., Praparattanapan J., Kantipong P., Kambua P., Ratanasuwan W., Sriondee R., Nguyen V.K., Bui V.H., Cao T.T., Pham T.T., Cuong D.D., Ha H.L., Sohn A.H., Durier N., Petersen B., Jiamsakul A., Boettiger D., Kelly M., Gibson A., Magon H., Donohue W., Moore R., Edwards S., Han N., Wright S.T., O'Connor C.C., Hoy J., Ponnampalavanar S., Grotowski M., Zhao H.X., Kamarulzaman A., Ellis D., Bloch M., Franic T., Agrawal S., McCann L., Cunningham N., Vincent T., Allen D., Little J.L., Smith D., Gray C., Baker D., Vale R., Templeton D.J., Dijanosic C., Jackson E., McCallum K., Taylor S., Cooper D.A., Carr A., Lee F., Hesse K., Sinn K., Norris R., Finlayson R., Prone I., Shakeshaft J., Brown K., McGrath C., McGrath V., Halligan S., Wray L., Read P., Lu H., Couldwell D., Furner V., Watson J., Giles M., Mulhall B., Law M., Petoumenos K., McManus H., Bendall C., Boyd M., Kulatunga A., Knibbs P., Chuah J., Ngieng M., Dickson B., Russell D., Downing S., Sowden D., Broom J., Taing K., Johnston C., McGill K., Orth D., Youds D., Liddle R., Locke P., Roth N.J., Nicolson J., Lau H., and Read T.

Abstract

Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Method(s): Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Result(s): A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusion(s): The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.Copyright © 2014 British HIV Association.

Published
2015

29. Trends in first-line antiretroviral therapy in Asia: Results from the treat Asia HIV Observational Database

Author

Boettiger, DC, Kerr, S, Ditangco, R, Merati, TP, Pham, TTT, Chaiwarith, R, Kiertiburanakul, S, Li, CKP, Kumarasamy, N, Vonthanak, S, Lee, C, Van Kinh, N, Pujari, S, Wong, WW, Kamarulzaman, A, Zhang, F, Yunihastuti, E, Choi, JY, Oka, S, Ng, OT, Kantipong, P, Mustafa, M, Ratanasuwan, W, Sohn, A, Law, M, Boettiger, DC, Kerr, S, Ditangco, R, Merati, TP, Pham, TTT, Chaiwarith, R, Kiertiburanakul, S, Li, CKP, Kumarasamy, N, Vonthanak, S, Lee, C, Van Kinh, N, Pujari, S, Wong, WW, Kamarulzaman, A, Zhang, F, Yunihastuti, E, Choi, JY, Oka, S, Ng, OT, Kantipong, P, Mustafa, M, Ratanasuwan, W, Sohn, A, and Law, M

Abstract

Background: Antiretroviral therapy (ART) has evolved rapidly since its beginnings. This analysis describes trends in first-line ART use in Asia and their impact on treatment outcomes.

Published
2014

30. Loss to Followup in HIV-Infected Patients from Asia-Pacific Region: Results from TAHOD

Author

Zhou, J, Tanuma, J, Chaiwarith, R, Lee, CKC, Law, MG, Kumarasamy, N, Phanuphak, P, Chen, Y-MA, Kiertiburanakul, S, Zhang, F, Vonthanak, S, Ditangco, RA, Pujari, S, Choi, JY, Merati, TP, Yunihastuti, E, Li, PCK, Kamarulzaman, A, Nguyen, VK, Pham, TT, Lim, PL, Zhou, J, Tanuma, J, Chaiwarith, R, Lee, CKC, Law, MG, Kumarasamy, N, Phanuphak, P, Chen, Y-MA, Kiertiburanakul, S, Zhang, F, Vonthanak, S, Ditangco, RA, Pujari, S, Choi, JY, Merati, TP, Yunihastuti, E, Li, PCK, Kamarulzaman, A, Nguyen, VK, Pham, TT, and Lim, PL

Abstract

This study examined characteristics of HIV-infected patients in the TREAT Asia HIV Observational Database who were lost to follow-up (LTFU) from treatment and care. Time from last clinic visit to 31 March 2009 was analysed to determine the interval that best classified LTFU. Patients defined as LTFU were then categorised into permanently LTFU (never returned) and temporary LTFU (re-entered later), and these groups compared. A total of 3626 patients were included (71% male). No clinic visits for 180 days was the best-performing LTFU definition (sensitivity 90.6%, specificity 92.3%). During 7697 person-years of follow-up, 1648 episodes of LFTU were recorded (21.4 per 100-person-years). Patients LFTU were younger, had HIV viral load ¡Ý500 copies/mL or missing, had shorter history of HIV infection, and received no, single- or double-antiretroviral therapy, or a triple-drug regimen containing a protease inhibitor. 48% of patients LTFU never returned. These patients were more likely to have low or missing haemoglobin, missing recent HIV viral load, negative hepatitis C test, and previous temporary LTFU episodes. Our analyses suggest that patients not seen at a clinic for 180 days are at high risk of permanent LTFU, and should be aggressively traced.

Published
2012

35. Poster Session 4

Author

Tada, H., primary, Yamasaki, H., additional, Sekiguchi, Y., additional, Igarashi, M., additional, Kuroki, K., additional, Machino, T., additional, Yoshida, K., additional, Aonuma, K., additional, Heinzel, F. R., additional, Forstner, H., additional, Lercher, P., additional, Bisping, E., additional, Rotman, B., additional, Fruhwald, F. M., additional, Pieske, B. M., additional, Dabrowski, R., additional, Kowalik, I., additional, Borowiec, A., additional, Smolis-Bak, E., additional, Trybuch, A., additional, Sosnowski, C., additional, Szwed, H., additional, Baturova, M. A., additional, Lindgren, A., additional, Shubik, Y. V., additional, Olsson, B., additional, Platonov, P. G., additional, Van Den Broek, K. C., additional, Denollet, J., additional, Widdershoven, J., additional, Kupper, N., additional, Allam, R., additional, Allam, R. A. G. A. B., additional, Galal, W. A. G. D. Y., additional, El-Damnhoury, H. A. Y. A. M., additional, Mortada, A. Y. M. A. N., additional, Jimenez-Candil, J., additional, Martin, A., additional, Hernandez, J., additional, Martin, F., additional, Gallego, M., additional, Martin-Luengo, C., additional, Quintanilla, J. G., additional, Moreno Planas, J., additional, Molina-Morua, R., additional, Archondo, T., additional, Garcia-Torrent, M. J., additional, Perez-Castellano, N., additional, Macaya, C., additional, Perez-Villacastin, J., additional, Saiz, J., additional, Tobon, C., additional, Rodriguez, J. F., additional, Hornero, F., additional, Ferrero, J. M., additional, Ito, K., additional, Date, T., additional, Kawai, M., additional, Hioki, M., additional, Narui, R., additional, Matsuo, S., additional, Yoshimura, M., additional, Yamane, T., additional, Tabatabaei, N., additional, Lin, G., additional, Powell, B. D., additional, Smairat, R., additional, Glockner, J. F., additional, Brady, P. A., additional, Fichtner, S., additional, Czudnochowsky, U., additional, Estner, H., additional, Reents, T., additional, Jilek, C., additional, Ammar, S., additional, Hessling, G., additional, Deisenhofer, I., additional, Shah, D. C., additional, Kautzner, J., additional, Saoudi, N., additional, Herrera, C., additional, Jais, P., additional, Hindricks, G., additional, Neuzil, P., additional, Kuck, K. H., additional, Wong, K. C. K., additional, Jones, M., additional, Qureshi, N., additional, Muthumala, A., additional, Betts, T. R., additional, Bashir, Y., additional, Rajappan, K., additional, Vogtmann, T., additional, Wagner, M., additional, Schurig, J., additional, Hein, P., additional, Hamm, B., additional, Baumann, G., additional, Lembcke, A., additional, Saad, B., additional, Slater, C., additional, Oliveira, L. A., additional, Elias, R., additional, Camiletti, A., additional, Moura, D., additional, Maldonado, P., additional, Camanho, L. E., additional, Bulava, A., additional, Hanis, J., additional, Sitek, D., additional, Novotny, A., additional, Chik, W. B., additional, Lim, T. W., additional, Choon, H. K., additional, See, V. A., additional, Mccall, R., additional, Thomas, L., additional, Ross, D. L., additional, Thomas, S. P., additional, Chen, J., additional, De Bortoli, A., additional, Rossvoll, O., additional, Hoff, P. I., additional, Solheim, E., additional, Sun, L. Z., additional, Schuster, P., additional, Ohm, O. J., additional, Ardashev, A. V., additional, Zhelyakov, E., additional, Rybachenko, M. S., additional, Konev, A. V., additional, Belenkov, Y. U. N., additional, Gunawardene, M., additional, Chun, K. R. J., additional, Schulte-Hahn, B., additional, Windhorst, V., additional, Kulikoglu, M., additional, Nowak, B., additional, Schmidt, B., additional, Albina, G. A., additional, Rivera, R. S., additional, Scazzuso, F., additional, Laino, R. L., additional, Giniger, G. A., additional, Arbelo, E., additional, Calvo, N., additional, Tamborero, D., additional, Andreu, D., additional, Borras, R., additional, Berruezo, A., additional, Brugada, J., additional, Mont, L., additional, Stefan, L., additional, Eisenberger, M., additional, Celentano, E., additional, Peytchev, P., additional, Bodea, O., additional, Geelen, P., additional, De Potter, T., additional, Oliveira, M. M., additional, Silva, N., additional, Cunha, P. S., additional, Feliciano, J., additional, Lousinha, A., additional, Toste, A., additional, Santos, S., additional, Ferreira, R. C., additional, Matsuda, H., additional, Harada, T., additional, Soejima, K., additional, Ishikawa, Y., additional, Mizukoshi, K., additional, Sasaki, T., additional, Mizuno, K., additional, Miyake, F., additional, Adragao, P. P., additional, Cavaco, D., additional, Miranda, R., additional, Santos, M., additional, Morgado, F., additional, Reis Santos, K., additional, Candeias, R., additional, Marcelino, S., additional, Zoppo, F., additional, Grandolino, G., additional, Zerbo, F., additional, Bertaglia, E., additional, Schlueter, S. M., additional, Grebe, O., additional, Vester, E. G., additional, Miracle Blanco, A. L., additional, Arenal Maiz, A., additional, Atienza Fernandez, F., additional, Datino Romaniega, T., additional, Gonzalez Torrecilla, E., additional, Eidelman, G., additional, Hernandez Hernandez, J., additional, Fernandez Aviles, F., additional, Fukumoto, K., additional, Takatsuki, S., additional, Kimura, T., additional, Nishiyama, N., additional, Aizawa, Y., additional, Sato, T., additional, Miyoshi, S., additional, Fukuda, K., additional, Richter, B., additional, Gwechenberger, M., additional, Socas, A., additional, Zorn, G., additional, Albinni, S., additional, Marx, M., additional, Wojta, J., additional, Goessinger, H., additional, Deneke, T., additional, Balta, O., additional, Paesler, M., additional, Buenz, K., additional, Anders, H., additional, Horlitz, M., additional, Muegge, A., additional, Shin, D.- I., additional, Natsuyama, K., additional, Yamaguchi, K. M., additional, Nishida, Y. N., additional, Kosiuk, J., additional, Bode, K., additional, Arya, A., additional, Piorkowski, C., additional, Gaspar, T., additional, Sommer, P., additional, Bollmann, A., additional, Wichterle, D., additional, Peichl, P., additional, Simek, J., additional, Havranek, S., additional, Bulkova, V., additional, Cihak, R., additional, Jurado Roman, A., additional, Salguero Bodes, R., additional, Lopez Gil, M., additional, Fontenla Cerezuela, A., additional, De Riva Silva, M., additional, Arribas Ynsaurriaga, F., additional, Fernandez Herranz, A. I., additional, De Dios Perez, S., additional, Revishvili, A. S., additional, Dishekov, M., additional, Tembotova, Z., additional, Barsamyan, S., additional, Vaccari, D., additional, Alvarenga, C., additional, Jesus, I., additional, Layher, J., additional, Takahashi, A., additional, Singh, N., additional, Siot, P., additional, Elkaim, J. P., additional, Savelieva, I., additional, Mcclelland, L., additional, Lovegrove, A., additional, Jones, S., additional, Camm, J., additional, Folino, A. F., additional, Breda, R., additional, Calzavara, P., additional, Comisso, J., additional, Borghetti, F., additional, Iliceto, S., additional, Buja, G., additional, Mlynarski, R., additional, Mlynarska, A., additional, Sosnowski, M., additional, Wilczek, J., additional, Mabo, P., additional, Carrault, G., additional, Bordachar, P., additional, Makdissi, A., additional, Duchemin, L., additional, Alonso, C., additional, Neri, G., additional, Masaro, G., additional, Vittadello, S., additional, Gardin, A., additional, Barbetta, A., additional, Di Gregorio, F., additional, Sciaraffia, E., additional, Ginks, M. R., additional, Gustafsson, J. S., additional, Hollmark, M. C., additional, Rinaldi, C. A., additional, Blomstrom Lundqvist, C., additional, Brusich, S., additional, Tomasic, D., additional, Ferek-Petric, B., additional, Mavric, Z., additional, Kutarski, A., additional, Malecka, B., additional, Kolodzinska, A., additional, Grabowski, M., additional, Dovellini, E. V., additional, Giurlani, L., additional, Cerisano, G., additional, Carrabba, N., additional, Valenti, R., additional, Antoniucci, D., additional, Opolski, G., additional, Tomassoni, G., additional, Baker, J., additional, Corbisiero, R., additional, Martin, D., additional, Niazi, I., additional, Sheppard, R., additional, Sperzel, J., additional, Gutleben, K., additional, Petru, J., additional, Sediva, L., additional, Skoda, J., additional, Mazzone, P., additional, Ciconte, G., additional, Vergara, P., additional, Marzi, A., additional, Paglino, G., additional, Sora, N., additional, Gulletta, S., additional, Della Bella, P., additional, Pietura, R., additional, Czajkowski, M., additional, Cabanelas, N., additional, Martins, V. P., additional, Alves, M., additional, Valente, F. X., additional, Marta, L., additional, Francisco, A., additional, Silva, R., additional, Ferreira Da Silva, G., additional, Huo, Y., additional, Holmqvist, F., additional, Carlson, J., additional, Wetzel, U., additional, Platonov, P., additional, Nof, E., additional, Abu Shama, R., additional, Kuperstein, R., additional, Feinberg, M. S., additional, Eldar, M., additional, Glikson, M., additional, Luria, D., additional, Kubus, P., additional, Materna, O., additional, Gebauer, R. A., additional, Matejka, T., additional, Gebauer, R., additional, Tlaskal, T., additional, Janousek, J., additional, Muessigbrodt, A., additional, Richter, S., additional, Stockburger, M., additional, Boveda, S., additional, Defaye, P., additional, Stancak Branislav, P., additional, Kaliska, G., additional, Rolando, M., additional, Moreno, J., additional, Ohlow, M.- A. G., additional, Lauer, B., additional, Buchter, B., additional, Schreiber, M., additional, Geller, J. C., additional, Val-Mejias, J. E., additional, Ouali, S., additional, Azzez, S., additional, Kacem, S., additional, Ben Salem, H., additional, Hammas, S., additional, Neffeti, E., additional, Remedi, F., additional, Boughzela, E., additional, Miyazaki, H., additional, Miyanaga, S., additional, Shibayama, K., additional, Tokuda, M., additional, Kudo, T., additional, Coppola, B., additional, Shehada, R. E. N., additional, Costandi, P., additional, Healey, J., additional, Hohnloser, S. H., additional, Gold, M. R., additional, Capucci, A., additional, Van Gelder, I. C., additional, Carlson, M., additional, Lau, C. P., additional, Connolly, S. J., additional, Bogaard, M. D., additional, Leenders, G. E., additional, Maskara, B., additional, Tuinenburg, A. E., additional, Loh, P., additional, Hauer, R. N., additional, Doevendans, P. A., additional, Meine, M., additional, Thibault, B., additional, Dubuc, M., additional, Karst, E., additional, Ryu, K., additional, Paiement, P., additional, Farazi, T., additional, Puetz, V., additional, Berndt, C., additional, Buchholz, J., additional, Dorszewski, A., additional, Mornos, C., additional, Cozma, D., additional, Ionac, A., additional, Petrescu, L., additional, Mornos, A., additional, Pescariu, S., additional, Benser, M., additional, Roscoe, G., additional, De Jong, S., additional, Roberts, G., additional, Boileau, P., additional, Rec, A., additional, Folman, C., additional, Morttada, A., additional, Abd El Kader, M., additional, Samir, R., additional, Roushdy, R., additional, Khaled, S., additional, Abo El Maaty, M., additional, Van Gelder, B., additional, Houthuizen, P., additional, Bracke, F. A., additional, Osca Asensi, J., additional, Tejada, D., additional, Sanchez, J. M., additional, Munoz, B., additional, Cano, O., additional, Rodriguez, M., additional, Sancho-Tello, M. J., additional, Olague, J., additional, Hou, W., additional, Rosenberg, S., additional, Koh, S., additional, Poore, J., additional, Snell, J., additional, Yang, M., additional, Nirav, D., additional, Bornzin, G., additional, Deering, T., additional, Dan, D., additional, Wickliffe, A. C., additional, Cazeau, S., additional, Karimzadeh, K., additional, Mukerji, S., additional, Loghin, C., additional, Kantharia, B., additional, Jones, M. A., additional, Lamba, J., additional, Simpson, C. S., additional, Redfearn, D. P., additional, Michael, K. A., additional, Fitzpatrick, M., additional, Baranchuk, A., additional, Heinke, M., additional, Ismer, B., additional, Kuehnert, H., additional, Surber, R., additional, Haltenberger, A. M., additional, Prochnau, D., additional, Figulla, H. R., additional, Delarche, N., additional, Bizeau, O., additional, Couderc, P., additional, Chapelet, A., additional, Amara, W., additional, Lazarus, A., additional, Krupickova, S., additional, Van Deursen, C. J. M., additional, Strik, M., additional, Vernooy, K., additional, Van Hunnik, A., additional, Kuiper, M., additional, Crijns, H. J. G. M., additional, Prinzen, F. W., additional, Islam, N., additional, Gras, D., additional, Abraham, W., additional, Calo, L., additional, Birgersdotter-Green, U., additional, Clyne, C., additional, Herre, J., additional, Klein, N., additional, Kowalski, O., additional, Lenarczyk, R., additional, Pruszkowska, P., additional, Sokal, A., additional, Kukulski, T., additional, Zielinska, T., additional, Pluta, S., additional, Kalarus, Z., additional, Schwab, J. O., additional, Gasparini, M., additional, Anselme, F., additional, Clementy, J., additional, Santini, M., additional, Martinez Ferrer, J., additional, Burrone, V., additional, Santi, E., additional, Nevzorov, R., additional, Porter, A., additional, Kusniec, J., additional, Golovchiner, G., additional, Ben-Gal, T., additional, Strasberg, B., additional, Haim, M., additional, Rordorf, R., additional, Savastano, S., additional, Sanzo, A., additional, Vicentini, A., additional, Petracci, B., additional, De Amici, M., additional, Striuli, L., additional, Landolina, M., additional, Tolosana, J. M., additional, Martin, A. M., additional, Hernandez-Madrid, A., additional, Macias, A., additional, Fernandez-Lozano, I., additional, Osca, J., additional, Quesada, A., additional, Tada, H., additional, Noguchi, Y., additional, Shahrzad, S., additional, Karim Soleiman, N., additional, Tavoosi, A., additional, Taban, S., additional, Emkanjoo, Z., additional, Fukunaga, M., additional, Goya, M., additional, Hiroshima, K., additional, Ohe, M., additional, Hayashi, K., additional, Iwabuchi, M., additional, Nosaka, H., additional, Nobuyoshi, M., additional, Doiny, D., additional, Perez-Silva, A., additional, Castrejon Castrejon, S., additional, Estrada, A., additional, Ortega, M., additional, Lopez-Sendon, J. L., additional, Merino, J. L., additional, Garcia Fernandez, F. J., additional, Gallardo, R., additional, Pachon, M., additional, Almendral, J., additional, Martin, J., additional, Yahya, D., additional, Al-Mogheer, B., additional, Gouda, S., additional, Eweis, E., additional, El Ramly, M., additional, Abdelwahab, A., additional, Kassenberg, W., additional, Wittkampf, F. H. M., additional, Hof, I. E., additional, Heijden, J. H., additional, Neven, K. G. E. J., additional, Hauer, R. N. W., additional, Baratto, F., additional, Bignami, E., additional, Pappalardo, F., additional, Maccabelli, G., additional, Nicolotti, D., additional, Zangrillo, A., additional, Nagashima, M., additional, An, Y., additional, Okreglicki, A., additional, Russouw, C., additional, Tilz, R., additional, Yoshiga, Y., additional, Mathew, S., additional, Fuernkranz, A., additional, Rillig, A., additional, Wissner, E., additional, Ouyang, F., additional, De Sisti, A., additional, Tonet, J., additional, Gueffaf, F., additional, Touil, F., additional, Aouate, P., additional, Hidden-Lucet, F., additional, Makimoto, H., additional, Satomi, K., additional, Yamada, Y., additional, Okamura, H., additional, Noda, T., additional, Shimizu, W., additional, Aihara, N., additional, Kamakura, S., additional, Perez Silva, A., additional, Castrejon, S., additional, Gonzalez Vasserot, M., additional, Senges, J., additional, Brachmann, J., additional, Andresen, D., additional, Hoffmann, E., additional, Schumacher, B., additional, Willems, S., additional, Springer, B., additional, Kolb, C., additional, Akca, F., additional, Bauernfeind, T., additional, De Groot, N. M. S., additional, Schwagten, B., additional, Witsenburg, M., additional, Jordaens, L., additional, Szili-Torok, T., additional, Hata, Y., additional, Nakagami, R., additional, Watanabe, T., additional, Sato, A., additional, Watanabe, H., additional, Kabutoya, T., additional, Mituhashi, T., additional, Theuns, D. A. M. J., additional, Smith, T., additional, Pedersen, S. S., additional, Dabiri-Abkenari, L., additional, Prull, M. W., additional, Unverricht, S., additional, Bittlinsky, A., additional, Wirdemann, H., additional, Sasko, B., additional, Wirdeier, S., additional, Trappe, H. J., additional, Zorio Grima, E., additional, Rueda, J., additional, Medina, P., additional, Jaijo, T., additional, Sevilla, T., additional, Arnau, M. A., additional, Salvador, A., additional, Starrenburg, A. H., additional, Kraaier, K., additional, Scholten, M. F., additional, Van Der Palen, J., additional, De Haan, S., additional, Commandeur, J., additional, De Boer, K., additional, Beek, A. M., additional, Van Rossum, A. C., additional, Allaart, C. P., additional, Berne, P., additional, Porres, J. M., additional, Arnaiz, J. A., additional, Brugada, R., additional, Man, S., additional, Maan, A. C., additional, Thijssen, J., additional, Van Der Wall, E. E., additional, Schalij, M. J., additional, Burattini, L., additional, Burattini, R., additional, Swenne, C. A., additional, Bonny, A., additional, Ditah, I., additional, Larrazet, F., additional, Frank, R., additional, Fontaine, G., additional, Van Der Voort, P. H., additional, Alings, M., additional, Shimane, A., additional, Okajima, K., additional, Kanda, G., additional, Yokoi, K., additional, Yamada, S., additional, Taniguchi, Y., additional, Hayashi, T., additional, Kajiya, T., additional, Santos, M. C., additional, Wright, J., additional, Betts, J., additional, Denman, R., additional, Dominguez-Perez, L., additional, Arias Palomares, M. A., additional, Toquero, J., additional, Diaz-Infante, E., additional, Tercedor, L., additional, Valverde, I., additional, Napp, A., additional, Joosten, S., additional, Stunder, D., additional, Zink, M., additional, Marx, N., additional, Schauerte, P., additional, Silny, J., additional, Trucco, M. E., additional, Arce, M., additional, Palazzolo, J., additional, Femenia, F., additional, Glad, J. M., additional, Szymkiewicz, S. J., additional, Fernandez-Armenta, J., additional, Camara, O., additional, Mont, L. L., additional, Diaz, E., additional, Silva, E., additional, Frangi, A., additional, Brembilla-Perrot, B., additional, Laporte, F., additional, Morinigo, J., additional, Ledesma, C., additional, Hadid, C., additional, Ortiz, M., additional, Wolpert, C., additional, Cobo, E., additional, Navarro, X., additional, Arribas, F., additional, Miki, Y., additional, Naitoh, S., additional, Kumagai, K., additional, Goto, K., additional, Kaseno, K., additional, Oshima, S., additional, Taniguchi, K., additional, Rivera, S., additional, Albina, G., additional, Klein, A., additional, Laino, R., additional, Sammartino, V., additional, Giniger, A., additional, Muggenthaler, M., additional, Raju, H., additional, Papadakis, M., additional, Chandra, N., additional, Bastiaenen, R., additional, Behr, E. R., additional, Sharma, S., additional, Samniah, N., additional, Radezishvsky, Y., additional, Omari, H., additional, Rosenschein, U., additional, Perez Riera, A. R., additional, Ferreira, M., additional, Hopman, W. M., additional, Mcintyre, W. F., additional, Baranchuk, A. R., additional, Wongcharoen, W., additional, Keanprasit, K., additional, Phrommintikul, A., additional, Chaiwarith, R., additional, Yagishita, A., additional, Hachiya, H., additional, Nakamura, T., additional, Tanaka, Y., additional, Higuchi, K., additional, Kawabata, M., additional, Hirao, K., additional, Isobe, M., additional, Stoickov, V., additional, Ilic, S., additional, Deljanin Ilic, M., additional, Aagaard, P., additional, Sahlen, A., additional, Bergfeldt, L., additional, Braunschweig, F., additional, Sousa, A., additional, Lebreiro, A., additional, Sousa, C., additional, Oliveira, S., additional, Correia, A. S., additional, Rangel, I., additional, Freitas, J., additional, Maciel, M. J., additional, Asensio Lafuente, E., additional, Aguilera, A. A. C., additional, Corral, M. A. C. C., additional, Mendoza, K. L. M. C., additional, Nava, P. E. N. 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B., additional, Adragao, P., additional, Fatemi, M., additional, Didier, R., additional, Le Gal, G., additional, Etienne, Y., additional, Jobic, Y., additional, Gilard, M., additional, Boschat, J., additional, Mansourati, J., additional, Zubaid, M., additional, Rashed, W., additional, Alsheikh-Ali, A., additional, Almahmeed, W., additional, Shehab, A., additional, Sulaiman, K., additional, Asaad, N., additional, Amin, H., additional, Boersma, L. V. A., additional, Swaans, M., additional, Post, M., additional, Rensing, B., additional, Jarverud, K., additional, Broome, M., additional, Noren, K., additional, Svensson, T., additional, Hjelm, S., additional, Hollmark, M., additional, Bjorling, A., additional, Maeda, K., additional, Takagi, M., additional, Suzuki, K., additional, Tatsumi, H., additional, Yoshiyama, M., additional, Simeonidou, E., additional, Michalakeas, C., additional, Kastellanos, S., additional, Varounis, C., additional, Nikolopoulou, A., additional, Koniari, C., additional, Anastasiou-Nana, M., additional, Furukawa, T., additional, Maggi, R., additional, Bertolone, C., additional, Fontana, D., additional, Brignole, M., additional, Pietrucha, A. Z., additional, Wnuk, M., additional, Bzukala, I., additional, Mroczek-Czernecka, D., additional, Konduracka, E., additional, Kruszelnicka, O., additional, Piwowarska, W., additional, Nessler, J., additional, Edvardsson, N., additional, Rieger, G., additional, Garutti, C., additional, Linker, N., additional, Jorge, C., additional, Silva Marques, J., additional, Veiga, A., additional, Cruz, J., additional, Correia, M. J., additional, Sousa, J., additional, Miltenberger-Miltenyi, G., additional, Nunes Diogo, A., additional, Matic, D., additional, Mrdovic, I., additional, Stankovic, G., additional, Asanin, M., additional, Antonijevic, N., additional, Matic, M., additional, Kocev, N., additional, Vasiljevic, Z., additional, Ramirez-Marrero, M. A., additional, Perez-Villardon, B., additional, Delgado-Prieto, J. L., additional, Jimenez-Navarro, M., additional, De Teresa-Galvan, E., additional, De Mora-Martin, M., additional, Sztefko, K., additional, Malek, A., additional, De Groot, N., additional, Shalganov, T., additional, Schalij, M., additional, Rivas, N., additional, Casaldaliga, J., additional, Roca, I., additional, Pijuan, A., additional, Perez-Rodon, J., additional, Dos, L., additional, Garcia-Dorado, D., additional, Moya, A., additional, Baruteau, A.- E., additional, Behaghel, A., additional, Chatel, S., additional, Schott, J. J., additional, Daubert, J. C., additional, Le Marec, H., additional, Probst, V., additional, Navarro-Manchon, J., additional, Molina, P., additional, Igual, B., additional, Bermejo, M., additional, Giner, J., additional, Bourgonje, V. J. A., additional, Vos, M. A., additional, Ozdemir, S., additional, Doisne, N., additional, Van Der Heyden, M. A. G., additional, Van Veen, A. A. B., additional, Sipido, K., additional, Antoons, G., additional, Altieri, P. 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Published
2011
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39. Atherosclerotic cardiovascular disease screening and management protocols among adult HIV clinics in Asia

Author

Boettiger, D C, Law, M G, Ross, J, Huy, B V, Heng, Bsl, Ditangco, R, Kiertiburanakul, S, Avihingsanon, A, Cuong, D D, Kumarasamy, N, Kamarulzaman, A, Ly, P S, Yunihastuti, E, Parwati Merati, T, Zhang, F, Khusuwan, S, Chaiwarith, R, Lee, M P, Sangle, S, Choi, J Y, Ku, W W, Tanuma, J, Ng, O T, Sohn, A H, Wester, C W, Nash, D, Mugglin, Catrina, and Pujari, S

Subjects
610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract

Objectives Integration of HIV and non-communicable disease services improves the quality and efficiency of care in low- and middle-income countries (LMICs). We aimed to describe current practices for the screening and management of atherosclerotic cardiovascular disease (ASCVD) among adult HIV clinics in Asia. Methods Sixteen LMIC sites included in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific network were surveyed. Results Sites were mostly (81%) based in urban public referral hospitals. Half had protocols to assess tobacco and alcohol use. Protocols for assessing physical inactivity and obesity were in place at 31% and 38% of sites, respectively. Most sites provided educational material on ASCVD risk factors (between 56% and 75% depending on risk factors). A total of 94% reported performing routine screening for hypertension, 100% for hyperlipidaemia and 88% for diabetes. Routine ASCVD risk assessment was reported by 94% of sites. Protocols for the management of hypertension, hyperlipidaemia, diabetes, high ASCVD risk and chronic ischaemic stroke were in place at 50%, 69%, 56%, 19% and 38% of sites, respectively. Blood pressure monitoring was free for patients at 69% of sites; however, most required patients to pay some or all the costs for other ASCVD-related procedures. Medications available in the clinic or within the same facility included angiotensin-converting enzyme inhibitors (81%), statins (94%) and sulphonylureas (94%). Conclusion The consistent availability of clinical screening, diagnostic testing and procedures and the availability of ASCVD medications in the Asian LMIC clinics surveyed are strengths that should be leveraged to improve the implementation of cardiovascular care protocols.

43. Risk factors for toxoplasmosis in people living with HIV in the Asia-Pacific region.

Author

Lee KH, Jiamsakul A, Kiertiburanakul S, Borse R, Khol V, Yunihastuti E, Azwa I, Somia IKA, Chaiwarith R, Pham TN, Khusuwan S, Do CD, Kumarasamy N, Gani Y, Ditangco R, Ng OT, Pujari S, Lee MP, Avihingsanon A, Chen HP, Zhang F, Tanuma J, Ross J, and Choi JY

Subjects
Humans, Male, Risk Factors, Adult, Female, Asia epidemiology, Retrospective Studies, Case-Control Studies, Middle Aged, Prevalence, Prospective Studies, Toxoplasma, Toxoplasmosis epidemiology, Toxoplasmosis complications, HIV Infections epidemiology, HIV Infections complications
Abstract

Introduction: Toxoplasma gondii can cause symptomatic toxoplasmosis in immunodeficient hosts, including in people living with human immunodeficiency virus (PLWH), mainly because of the reactivation of latent infection. We assessed the prevalence of toxoplasmosis and its associated risk factors in PLWH in the Asia-Pacific region using data from the TREAT Asia Human Immunodeficiency Virus (HIV) Observational Database (TAHOD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) Asia-Pacific., Methods: This study included both retrospective and prospective cases of toxoplasmosis reported between 1997 and 2020. A matched case-control method was employed, where PLWH diagnosed with toxoplasmosis (cases) were each matched to two PLWH without a toxoplasmosis diagnosis (controls) from the same site. Sites without toxoplasmosis were excluded. Risk factors for toxoplasmosis were analyzed using conditional logistic regression., Results: A total of 269/9576 (2.8%) PLWH were diagnosed with toxoplasmosis in 19 TAHOD sites. Of these, 227 (84%) were reported retrospectively and 42 (16%) were prospective diagnoses after cohort enrollment. At the time of toxoplasmosis diagnosis, the median age was 33 years (interquartile range 28-38), and 80% participants were male, 75% were not on antiretroviral therapy (ART). Excluding 63 out of 269 people without CD4 values, 192 (93.2%) had CD4 ≤200 cells/μL and 162 (78.6%) had CD4 ≤100 cells/μL. By employing 538 matched controls, we found that factors associated with toxoplasmosis included abstaining from ART (odds ratio [OR] 3.62, 95% CI 1.81-7.24), in comparison to receiving nucleoside reverse transcriptase inhibitors plus non-nucleoside reverse transcriptase inhibitors, HIV exposure through injection drug use (OR 2.27, 95% CI 1.15-4.47) as opposed to engaging in heterosexual intercourse and testing positive for hepatitis B virus surface antigen (OR 3.19, 95% CI 1.41-7.21). Toxoplasmosis was less likely with increasing CD4 counts (51-100 cells/μL: OR 0.41, 95% CI 0.18-0.96; 101-200 cells/μL: OR 0.14, 95% CI 0.06-0.34; >200 cells/μL: OR 0.02, 95% CI 0.01-0.06), when compared to CD4 ≤50 cells/μL. Moreover, the use of prophylactic cotrimoxazole was not associated with toxoplasmosis., Conclusions: Symptomatic toxoplasmosis is rare but still occurs in PLWH in the Asia-Pacific region, especially in the context of delayed diagnosis, causing advanced HIV disease. Immune reconstitution through early diagnosis and ART administration remains a priority in Asian PLWH., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2024
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44. Rare Filaggrin Variants Are Associated with Pustular Skin Diseases in Asians.

Author

Lo Piccolo L, Wongkummool W, Jantaree P, Daroontum T, Chaowattanapanit S, Choonhakarn C, Amornpinyo W, Chaiwarith R, Kiratikanon S, Rujiwetpongstorn R, Tovanabutra N, Chiewchanvit S, Ngamphiw C, Intachai W, Kantaputra P, and Chuamanochan M

Subjects
Humans, Female, Male, Adult, Middle Aged, Exome Sequencing, Genetic Predisposition to Disease, Psoriasis genetics, Psoriasis pathology, Aged, Interferon-gamma genetics, Interferon-gamma metabolism, Autoantibodies immunology, Skin pathology, Skin metabolism, Filaggrin Proteins, Intermediate Filament Proteins genetics, Polymorphism, Single Nucleotide, Asian People genetics
Abstract

Reactive pustular eruptions (RPEs) can manifest in a variety of conditions, including pustular psoriasis (PP) and adult-onset immunodeficiency syndrome due to anti-interferon-γ autoantibody (AOID). These RPEs can be attributed to different causes, one of which is genetic factors. However, the genetic basis for pustular skin diseases remains poorly understood. In our study, we conducted whole-exome sequencing on a cohort of 17 AOID patients with pustular reactions (AOID-PR) and 24 PP patients. We found that 76% and 58% of the AOID-PR and PP patients, respectively, carried rare genetic variations within the filaggrin (FLG) gene family. A total of 12 out of 21 SNPs on FLG had previously received clinical classifications, with only p.Ser2706Ter classified as pathogenic. In contrast, none of the FLG3 SNPs identified in this study had prior clinical classifications. Overall, these variations had not been previously documented in cases of pustular disorders, and two of them were entirely novel discoveries. Immunohistochemical analysis of skin biopsies revealed that FLG variants like p.Ser860Trp, p.Gly3903Ter, p.Gly2440Glu, and p.Glu2133Asp caused reductions in FLG levels similar to the pathogenic FLG p.Ser2706Ter. These results highlight rare FLG variants as potential novel genetic risk factors contributing to pustule formation in both AOID and PP.

Published
2024
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45. Changes in atherosclerotic cardiovascular disease risk over time among people living with HIV.

Author

Chen W, Petoumenos K, Somia A, Edmiston N, Chaiwarith R, Woolley I, Ross J, Pujari S, and Boettiger DC

Subjects
Adult, Humans, Male, Adolescent, Female, HIV, Homosexuality, Male, Australia epidemiology, Risk Factors, Anti-HIV Agents therapeutic use, Cardiovascular Diseases epidemiology, Cardiovascular Diseases drug therapy, Sexual and Gender Minorities, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology, Atherosclerosis epidemiology
Abstract

Objective: To describe changes in atherosclerotic cardiovascular disease (ASCVD) risk over time among people living with HIV (PLHIV)., Methods: We used data from the TREAT Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD). Five-year ASCVD risk was calculated using the D:A:D equation. Individuals were eligible for inclusion if they were aged ≥18 years, had started ART, had no previous history of ASCVD and had complete ASCVD risk factor data available within the first 5 years of ART initiation., Results: A total of 3368 adults contributed data, 3221 were from TAHOD and 147 were from AHOD. The median age at ART initiation was 36 [IQR 31-43] years for TAHOD participants, and 42 [IQR 35-50] years for AHOD participants. Most TAHOD (70.4%) and AHOD (91.8%) participants were male. Overall, ASCVD risk increased from 0.84% (95% CI 0.81%-0.87%) at ART initiation to 1.34% (95% CI 1.29%-1.39%) after 5 years on ART. After adjusting for traditional and HIV-associated ASCVD risk factors, ASCVD risk increased at a similar rate among sub-populations defined by HIV exposure (heterosexuals, men who have sex with men, people who inject drugs), race/ethnicity (Caucasian and Asian) and nadir CD4 at ART initiation (<200 and ≥200 cells/mm3)., Conclusions: These findings emphasize the growing burden of ASCVD risk among PLHIV and the need to develop interventions that are effective across a broad range of HIV sub-populations., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2024
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46. Extracellular vesicles as potential diagnostic markers for kidney allograft rejection.

Author

Thongwitokomarn H, Noppakun K, Chaiwarith R, Chattipakorn SC, and Chattipakorn N

Subjects
Humans, Transplantation, Homologous, Biomarkers urine, Allografts, Graft Rejection diagnosis, Graft Rejection etiology, Kidney pathology, Extracellular Vesicles
Abstract

Kidney transplantation is a highly effective treatment for end-stage kidney disease. However, allograft rejection remains a significant clinical challenge in kidney transplant patients. Although kidney allograft biopsy is the gold-standard diagnostic method, it is an invasive procedure. Since the current monitoring methods, including screening of serum creatinine and urinary protein, are not of sufficient sensitivity, there is a need for effective post-transplant monitoring to detect allograft rejection at an early stage. Extracellular vesicles are vesicles with a lipid bilayer that originate from different cell types in pathological and physiological conditions. The content of extracellular vesicles reflects the status of cells at the time of their production. This review comprehensively summarizes clinical, in vivo, and in vitro reports that highlight the potential of extracellular vesicles as diagnostic biomarkers for kidney allograft rejection. Clarification would facilitate differentiation between rejection and non-rejection and identification of the mechanisms involved in the allograft rejection. Despite increasing evidence, further research is necessary to establish the clinical utility of extracellular vesicles in the diagnosis and monitoring of allograft rejection in kidney transplant recipients. Using extracellular vesicles as non-invasive biomarkers for diagnosis of kidney allograft rejection could have tremendous benefits in improving patient outcomes and reduce the need for invasive procedures., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2024
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47. Safety and immunogenicity of CoronaVac and ChAdOx1 heterologous prime-boost vaccines in an overweight population in Chiang Mai, Thailand.

Author

Chawansuntati K, Sakkhachornphop S, Hongjaisee S, Freeouf S, Sripan P, Nusartsang N, Chaiwarith R, Sudjaritruk T, Supparatpinyo K, and Wipasa J

Abstract

Background: In early 2021, the Ministry of Public Health of Thailand announced heterologous regimens for COVID-19 vaccines using CoronaVac as the first dose followed by ChAdOx1 nCoV-19 at 3 weeks apart. Priority was given to individuals above 60 years old and those who had seven underlying conditions, including obesity. The vaccine regimen was evaluated for safety and immunogenicity in overweight populations in Chiang Mai, Thailand., Methods: Participants who had a COVID-19 vaccination appointment for the heterologous prime-boost regimen were enrolled. Before each immunization and on day 28 following the second dosage, blood samples were taken, and were examined for anti-spike and neutralizing antibodies by using an indirect ELISA and virus neutralization assays. Safety profile of the vaccine regimen was assessed via a self-recorded diary of adverse events after each vaccination., Results: No serious adverse events related to vaccination were reported during study period and the majority of adverse reactions were fatigue and pain at the injection site. The levels of anti-spike IgG were 26.3, 56.4 and 1752.1 BAU/mL at baseline, 21 days after first dose and 28 days after second dose, respectively. At 4 weeks after complete vaccination, the median inhibition rates of neutralizing antibody determined by surrogate neutralization assay against wild type, Delta and Omicron variants were 95.2, 85.0 and 3.8, respectively. Moreover, the NT50 level against wild type and Delta variants determined by pseudotyped virus neutralization assay were 133.3 and 41.7, respectively. The neutralizing activity against Omicron variant was almost lower than cutoff level for detection., Conclusions: The heterologous CoronaVac-ChAdOx1vaccination was safe, well-tolerated and able to induce humoral immunity against wild-type and Delta variants but not against the Omicron variant in overweight population., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Published
2024
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48. Comparative immunohistochemical analysis of inflammatory cytokines in distinct subtypes of Sweet syndrome.

Author

Chieosilapatham P, Daroontum T, Suwansirikul S, Chaiwarith R, Phinyo P, Chaowattanapanit S, Choonhakarn C, Kiratikanon S, Rujiwetpongstorn R, Tovanabutra N, Chiewchanvit S, and Chuamanochan M

Subjects
Adult, Humans, Interleukin-17, Autoantibodies, Tumor Necrosis Factor-alpha, Cytokines metabolism, Sweet Syndrome
Abstract

Background: A dysregulated immune response has been implicated in Sweet syndrome (SS) pathogenesis; however, cytokine profiles across different conditions associated with SS - including adult-onset immunodeficiency (AOID) due to anti-interferon (IFN)-γ autoantibodies - remain unknown., Objective: To investigate alterations in inflammatory cytokines in skin lesions of distinct subtypes of SS., Methods: Skin biopsies were collected from 42 AOID- and 52 non-AOID-associated SS patients and 18 healthy controls. The comparative immunohistochemical study was conducted using monoclonal antibodies against interleukin (IL)-1β, IL-6, IL-17, IFN-γ, and tumor necrosis factor-α on paraffin-embedded sections. The quantitative percentage positivity and intensity were calculated using computer-based image analysis., Results: The results showed stronger and more diffuse dermal immunoreactivity for IFN-γ and IL-17 in the AOID-associated ( p < 0.001 and p < 0.001, respectively) and non-AOID-associated SS ( p < 0.001 and p < 0.001, respectively) groups. However, no significant differences in the levels of these two cytokines were observed between the AOID- and non-AOID-associated SS groups. Increased expression of IFN-γ together with IL-17 was also noted in almost all subtypes among non-AOID-associated SS., Conclusions: These results demonstrate that IFN-γ and IL-17 are implicated in immunopathology of all SS subtypes, including AOID-associated SS, despite the presence of anti-IFN-γ autoantibodies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chieosilapatham, Daroontum, Suwansirikul, Chaiwarith, Phinyo, Chaowattanapanit, Choonhakarn, Kiratikanon, Rujiwetpongstorn, Tovanabutra, Chiewchanvit and Chuamanochan.)

Published
2024
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49. Human Leukocyte Antigen Markers for Distinguishing Pustular Psoriasis and Adult-Onset Immunodeficiency with Pustular Reaction.

Author

Sangphukieo A, Thongkumkoon P, Noisagul P, Lo Piccolo L, O'Brien TE, Chaowattanapanit S, Choonhakarn C, Amornpinyo W, Chaiwarith R, Kiratikanon S, Rujiwetpongstorn R, Tovanabutra N, Chiewchanvit S, Kantaputra P, Intachai W, Dissook S, and Chuamanochan M

Subjects
Adult, Humans, Histocompatibility Antigens Class II, HLA Antigens genetics, Autoantibodies, Psoriasis diagnosis, Psoriasis genetics, Skin Diseases, Vesiculobullous
Abstract

Pustular skin diseases, with pustular psoriasis (PP) being the prototype, are immune-mediated diseases characterized by the presence of multiple pustules, resulting from neutrophil accumulation in the layer of epidermis. Sterile skin pustular eruption, like PP, is also observed in 20-30% of patients with adult-onset immunodeficiency syndrome (AOID) and anti-interferon γ autoantibodies (IFN-γ), leading to challenges in classification and diagnosis. While the mechanism underlying this similar phenotype remains unknown, genetic factors in relation to the immune system are suspected of playing an important role. Here, the association between human leukocyte antigen (HLA) genes, which play essential roles in antigen presentation, contributing to immune response, and the presence of skin pustules in AOID and PP was revealed. HLA genotyping of 41 patients from multiple centers in Thailand who presented with multiple sterile skin pustules (17 AOID patients and 24 PP patients) was conducted using a next-generation-sequencing-based approach. In comparison to healthy controls, HLA-B*13:01 (OR = 3.825, 95%CI: 2.08-7.035), C*03:04 (OR = 3.665, 95%CI: 2.102-6.39), and DQB1*05:02 (OR = 2.134, 95%CI: 1.326-3.434) were significantly associated with the group of aforementioned conditions having sterile cutaneous pustules, suggesting a common genetic-related mechanism. We found that DPB1*05:01 (OR = 3.851, p = 0.008) and DRB1*15:0 2 (OR = 3.195, p = 0.033) have a significant association with pustular reaction in AOID patients, with PP patients used as a control. A variant in the DRB1 gene, rs17885482 (OR = 9.073, p = 0.005), was observed to be a risk factor for PP when using AOID patients who had pustular reactions as a control group. DPB1*05:01 and DRB1*15:0 2 alleles, as well as the rs17885482 variant in the DRB1 gene, were proposed as novel biomarkers to differentiate PP and AOID patients who first present with multiple sterile skin pustules without known documented underlying conditions.

Published
2024
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50. Health Behaviors and Attitudes Toward HIV Clinic Among Young Men who Have Sex with Men Living with HIV in Chiang Mai, Thailand: A Mixed Methods Study.

Author

Aurpibul L, Kaewpoowat Q, Detsakunathiwatchara C, Chairat S, Chaiwarith R, and Tangmunkongvorakul A

Subjects
Male, Humans, Young Adult, Adult, Homosexuality, Male, Thailand epidemiology, Cross-Sectional Studies, Sexual Behavior, Health Behavior, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections prevention & control, Sexual and Gender Minorities
Abstract

Today, many young men who have sex with men (YMSM) with a new HIV infection were diagnosed and successfully linked to HIV services. Studies on their health behaviors while living with HIV and their attitude toward the HIV clinic are scarce. We characterized common health behaviors of YMSM and assessed their perspective towards the existing HIV services. We collected data from a self-administered questionnaire and in-depth interviews (IDI) using a mixed-method cross-sectional study design. A hundred YMSM, aged 18-24, who attended the HIV clinic were enrolled. Their median age was 23 years (interquartile range, IQR 21-24). Eighty-four (84%) were gay men. Their common health behaviors included 15 (15%) being current smokers and 30 (30%) using alcohol regularly. Sixty-four (64%) reported > 95% antiretroviral treatment adherence, while 32 (32%) self-reported adherence at 80-95%. Fifty-three (53%) reported 100% condom use, while 30 (30%) reported using a condom in > 80% of their sexual activities. From the questionnaire respondents, individual characteristics of providers were the most critical factor affecting participants' willingness to attend HIV services. From the IDI, social disclosure of HIV status was their primary concern, with the presence of self- and anticipating HIV-related stigma issues. In summary, YMSM living with HIV who regularly attended the HIV clinic had a low frequency of health risk behaviors. Most did not socially disclose their serostatus but could manage their health. They were generally satisfied with patient-friendly services while calling to protect their confidentiality and privacy., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2024
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