Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy
Background: Current guidelines for HIV management recommend monitoring plasma HIV-1 RNA level every 3-6 months in patients on a stable antiretroviral regimen. However, cost is the major obstacle to follow the guidelines in resource-limited settings. Objective: This study aimed to compare the outcome...
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th-cmuir.6653943832-500482018-09-04T04:27:55Z Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy Romanee Chaiwarith Jutarat Praparattanapan Nontakan Nuntachit Wilai Kotarathitithum Thira Sirisanthana Khuanchai Supparatpinyo Immunology and Microbiology Medicine Background: Current guidelines for HIV management recommend monitoring plasma HIV-1 RNA level every 3-6 months in patients on a stable antiretroviral regimen. However, cost is the major obstacle to follow the guidelines in resource-limited settings. Objective: This study aimed to compare the outcome of antiretroviral therapy among HIV-infected patients on a stable regimen who had plasma HIV-1 RNA monitoring once vs twice yearly. Methods: A retrospective cohort study was conducted among HIV-infected patients receiving antiretroviral therapy since 2002 at Chiang Mai University Hospital, Thailand. We evaluated the incidence of virological failure and number of reverse transcriptase (RT) mutations between groups. Results: Of 551 patients on a stable antiretroviral regimen, 405 (73.5%) and 146 (26.5%) patients had plasma HIV-1 RNA measurement once and twice yearly, respectively. Forty-seven of 405 patients (11.6%) in once-yearly group and 15 of 146 patients (10.3%) in twice-yearly group developed virological failure, giving the incidence rate of 2.03/100 and 1.95/100 person-years, respectively. The probability of virological failure did not differ between groups (p=0.897, log-rank test). The number of RT mutations was not statistically different between groups (all p-values>0.05). The predicting factors for virological failure from a multivariate analysis were adherence rate <95% and baseline CD4 cell count <50 cells/mm3but not the frequency of HIV-1 RNA monitoring. Conclusions: The incidence of virological failure and the number of RT mutations were not different between groups. Therefore, in resource-limited settings, the recommendation to perform plasma HIV-1 RNA measurement once yearly in patients on a stable antiretroviral regimen is justified. © 2011 Bentham Science Publishers Ltd. 2018-09-04T04:22:35Z 2018-09-04T04:22:35Z 2011-01-01 Journal 1570162X 2-s2.0-79953320243 10.2174/157016211795569131 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79953320243&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/50048 |
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Immunology and Microbiology Medicine Romanee Chaiwarith Jutarat Praparattanapan Nontakan Nuntachit Wilai Kotarathitithum Thira Sirisanthana Khuanchai Supparatpinyo Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
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Background: Current guidelines for HIV management recommend monitoring plasma HIV-1 RNA level every 3-6 months in patients on a stable antiretroviral regimen. However, cost is the major obstacle to follow the guidelines in resource-limited settings. Objective: This study aimed to compare the outcome of antiretroviral therapy among HIV-infected patients on a stable regimen who had plasma HIV-1 RNA monitoring once vs twice yearly. Methods: A retrospective cohort study was conducted among HIV-infected patients receiving antiretroviral therapy since 2002 at Chiang Mai University Hospital, Thailand. We evaluated the incidence of virological failure and number of reverse transcriptase (RT) mutations between groups. Results: Of 551 patients on a stable antiretroviral regimen, 405 (73.5%) and 146 (26.5%) patients had plasma HIV-1 RNA measurement once and twice yearly, respectively. Forty-seven of 405 patients (11.6%) in once-yearly group and 15 of 146 patients (10.3%) in twice-yearly group developed virological failure, giving the incidence rate of 2.03/100 and 1.95/100 person-years, respectively. The probability of virological failure did not differ between groups (p=0.897, log-rank test). The number of RT mutations was not statistically different between groups (all p-values>0.05). The predicting factors for virological failure from a multivariate analysis were adherence rate <95% and baseline CD4 cell count <50 cells/mm3but not the frequency of HIV-1 RNA monitoring. Conclusions: The incidence of virological failure and the number of RT mutations were not different between groups. Therefore, in resource-limited settings, the recommendation to perform plasma HIV-1 RNA measurement once yearly in patients on a stable antiretroviral regimen is justified. © 2011 Bentham Science Publishers Ltd. |
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Journal |
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Romanee Chaiwarith Jutarat Praparattanapan Nontakan Nuntachit Wilai Kotarathitithum Thira Sirisanthana Khuanchai Supparatpinyo |
author_facet |
Romanee Chaiwarith Jutarat Praparattanapan Nontakan Nuntachit Wilai Kotarathitithum Thira Sirisanthana Khuanchai Supparatpinyo |
author_sort |
Romanee Chaiwarith |
title |
Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
title_short |
Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
title_full |
Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
title_fullStr |
Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
title_full_unstemmed |
Impact of the frequency of plasma HIV-1 RNA monitoring on the outcome of antiretroviral therapy |
title_sort |
impact of the frequency of plasma hiv-1 rna monitoring on the outcome of antiretroviral therapy |
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2018 |
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https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79953320243&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/50048 |
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