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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Antiretroviral Treatment Interruption and Loss to Follow-Up in Two HIV Cohorts in Australia and Asia: Implications for ‘Test and Treat’ Prevention Strategy</title><author><name sortKey="Guy, Rebecca" sort="Guy, Rebecca" uniqKey="Guy R" first="Rebecca" last="Guy">Rebecca Guy</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Wand, Handan" sort="Wand, Handan" uniqKey="Wand H" first="Handan" last="Wand">Handan Wand</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Mcmanus, Hamish" sort="Mcmanus, Hamish" uniqKey="Mcmanus H" first="Hamish" last="Mcmanus">Hamish Mcmanus</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Vonthanak, Saphonn" sort="Vonthanak, Saphonn" uniqKey="Vonthanak S" first="Saphonn" last="Vonthanak">Saphonn Vonthanak</name><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Woolley, Ian" sort="Woolley, Ian" uniqKey="Woolley I" first="Ian" last="Woolley">Ian Woolley</name><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation></author><author><name sortKey="Honda, Miwako" sort="Honda, Miwako" uniqKey="Honda M" first="Miwako" last="Honda">Miwako Honda</name><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Read, Tim" sort="Read, Tim" uniqKey="Read T" first="Tim" last="Read">Tim Read</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Sirisanthana, Thira" sort="Sirisanthana, Thira" uniqKey="Sirisanthana T" first="Thira" last="Sirisanthana">Thira Sirisanthana</name><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author><author><name sortKey="Zhou, Julian" sort="Zhou, Julian" uniqKey="Zhou J" first="Julian" last="Zhou">Julian Zhou</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod, Andrew" sort="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod, Andrew" uniqKey="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod A" first="Andrew" last="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod">Andrew Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod</name><affiliation><nlm:aff id="aff7"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24320013</idno><idno type="pmc">3868400</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868400</idno><idno type="RBID">PMC:3868400</idno><idno type="doi">10.1089/apc.2012.0439</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001487</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001487</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Antiretroviral Treatment Interruption and Loss to Follow-Up in Two HIV Cohorts in Australia and Asia: Implications for ‘Test and Treat’ Prevention Strategy</title><author><name sortKey="Guy, Rebecca" sort="Guy, Rebecca" uniqKey="Guy R" first="Rebecca" last="Guy">Rebecca Guy</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Wand, Handan" sort="Wand, Handan" uniqKey="Wand H" first="Handan" last="Wand">Handan Wand</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Mcmanus, Hamish" sort="Mcmanus, Hamish" uniqKey="Mcmanus H" first="Hamish" last="Mcmanus">Hamish Mcmanus</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Vonthanak, Saphonn" sort="Vonthanak, Saphonn" uniqKey="Vonthanak S" first="Saphonn" last="Vonthanak">Saphonn Vonthanak</name><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Woolley, Ian" sort="Woolley, Ian" uniqKey="Woolley I" first="Ian" last="Woolley">Ian Woolley</name><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation></author><author><name sortKey="Honda, Miwako" sort="Honda, Miwako" uniqKey="Honda M" first="Miwako" last="Honda">Miwako Honda</name><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Read, Tim" sort="Read, Tim" uniqKey="Read T" first="Tim" last="Read">Tim Read</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Sirisanthana, Thira" sort="Sirisanthana, Thira" uniqKey="Sirisanthana T" first="Thira" last="Sirisanthana">Thira Sirisanthana</name><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author><author><name sortKey="Zhou, Julian" sort="Zhou, Julian" uniqKey="Zhou J" first="Julian" last="Zhou">Julian Zhou</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod, Andrew" sort="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod, Andrew" uniqKey="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod A" first="Andrew" last="Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod">Andrew Carr On Behalf Of Australia Hiv Observational Database Ahod And Treat Asia Hiv Observation Database Tahod</name><affiliation><nlm:aff id="aff7"></nlm:aff></affiliation></author></analytic><series><title level="j">AIDS Patient Care and STDs</title><idno type="ISSN">1087-2914</idno><idno type="eISSN">1557-7449</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p>Both antiretroviral treatment interruption (TI) and cessation have been strongly discouraged since 2006. We describe the incidence, duration, and risk factors for TI and loss-to-follow-up (LTFU) rates across 13 countries. All 4689 adults (76% men) in two large HIV cohorts in Australia and Asia commencing combination antiretroviral therapy (ART) to March 2010 were included. TI was defined by ART cessation >30 days, then recommencement, and loss to follow-up (LTFU) by no visit since 31 March 2009 and no record of death. Survival analysis and Poisson regression methods were used. With median follow-up of 4.4 years [interquartile range (IQR):2.1–6.5], TI incidence was 6.7 per 100 person years (PY) (95% CI:6.1–7.3) pre-2006, falling to 2.0 (95% CI:1.7–2.2) from 2006 (<italic>p</italic><0.01). LTFU incidence was 3.5 per 100 PY (95% CI:3.1–3.9) pre-2006, and 4.1 (95% CI:3.5–4.9) from 2006 (<italic>p</italic>=0.22). TIs accounted for 6.4% of potential time on ART pre-2006 and 1.2% from 2006 (<italic>p</italic><0.01), and LTFU 4.7% of potential time on ART pre-2006 and 6.6% from 2006 (<italic>p</italic><0.01). Median TI duration was 163 (IQR: 75–391) days pre-2006 and 118 (IQR: 67–270) days from 2006 (<italic>p</italic><0.01). Independent risk factors for the first TI were: Australia HIV Observational Database participation; ART initiation pre-2006; ART regimens including stavudine and didanosine; three nucleoside analogue reverse transcriptase inhibitors; ≥7 pills per day; and ART with food restrictions (fasting or with food). In conclusion, since 2006, 7.8% of patients had significant time off treatment, which has the potential to compromise any ‘test and treat’ policy as during the interruption viral load will rebound and increase the risk of transmission.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Patient Care STDS</journal-id><journal-id journal-id-type="iso-abbrev">AIDS Patient Care STDS</journal-id><journal-id journal-id-type="publisher-id">apc</journal-id><journal-title-group><journal-title>AIDS Patient Care and STDs</journal-title></journal-title-group><issn pub-type="ppub">1087-2914</issn><issn pub-type="epub">1557-7449</issn><publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name><publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24320013</article-id><article-id pub-id-type="pmc">3868400</article-id><article-id pub-id-type="publisher-id">10.1089/apc.2012.0439</article-id><article-id pub-id-type="doi">10.1089/apc.2012.0439</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical and Epidemiologic Research</subject></subj-group></article-categories><title-group><article-title>Antiretroviral Treatment Interruption and Loss to Follow-Up in Two HIV Cohorts in Australia and Asia: Implications for ‘Test and Treat’ Prevention Strategy</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Guy</surname><given-names>Rebecca</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Wand</surname><given-names>Handan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>McManus</surname><given-names>Hamish</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Vonthanak</surname><given-names>Saphonn</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Woolley</surname><given-names>Ian</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Honda</surname><given-names>Miwako</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Read</surname><given-names>Tim</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sirisanthana</surname><given-names>Thira</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zhou</surname><given-names>Julian</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Carr, on behalf of Australia HIV Observational Database (AHOD) and Treat Asia HIV Observation Database (TAHOD)</surname><given-names>Andrew</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><aff id="aff1"><label><sup>1</sup></label>The Kirby Institute,<institution>University of New South Wales</institution>, Sydney, NSW,<country>Australia</country>.</aff><aff id="aff2"><label><sup>2</sup></label><institution>National Center for HIV/AIDS</institution>, Dermatology & STDs, Phnom Penh,<country>Cambodia</country>.</aff><aff id="aff3"><label><sup>3</sup></label><institution>Monash Medical Centre and Monash University</institution>, Melbourne, VIC,<country>Australia</country>.</aff><aff id="aff4"><label><sup>4</sup></label><institution>National Center for Global Health and Medicine</institution>, Tokyo,<country>Japan</country>.</aff><aff id="aff5"><label><sup>5</sup></label><institution>Melbourne Sexual Health Centre</institution>, Melbourne, VIC,<country>Australia</country>.</aff><aff id="aff6"><label><sup>6</sup></label><institution>Research Institute for Health Sciences</institution>, Chiang Mai,<country>Thailand</country>.</aff><aff id="aff7"><label><sup>7</sup></label><institution>St Vincent's Hospital</institution>, Sydney, NSW,<country>Australia</country>.</aff></contrib-group><author-notes><corresp><addr-line>Address correspondence to:</addr-line><addr-line><italic>Rebecca Guy</italic></addr-line><addr-line><italic>The Kirby Institute</italic></addr-line><institution><italic>University of New South Wales</italic></institution><addr-line><italic>Sydney, NSW, 2052</italic></addr-line><country>Australia</country><break></break><italic>E-mail:</italic><email xlink:href="mailto:Rguy@kirby.unsw.edu.au">Rguy@kirby.unsw.edu.au</email></corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>12</month><year>2013</year></pub-date><volume>27</volume><issue>12</issue><fpage>681</fpage><lpage>691</lpage><permissions><copyright-statement>Copyright 2013, Mary Ann Liebert, Inc.</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="apc.2012.0439.pdf"></self-uri><abstract><title>Abstract</title><p>Both antiretroviral treatment interruption (TI) and cessation have been strongly discouraged since 2006. We describe the incidence, duration, and risk factors for TI and loss-to-follow-up (LTFU) rates across 13 countries. All 4689 adults (76% men) in two large HIV cohorts in Australia and Asia commencing combination antiretroviral therapy (ART) to March 2010 were included. TI was defined by ART cessation >30 days, then recommencement, and loss to follow-up (LTFU) by no visit since 31 March 2009 and no record of death. Survival analysis and Poisson regression methods were used. With median follow-up of 4.4 years [interquartile range (IQR):2.1–6.5], TI incidence was 6.7 per 100 person years (PY) (95% CI:6.1–7.3) pre-2006, falling to 2.0 (95% CI:1.7–2.2) from 2006 (<italic>p</italic><0.01). LTFU incidence was 3.5 per 100 PY (95% CI:3.1–3.9) pre-2006, and 4.1 (95% CI:3.5–4.9) from 2006 (<italic>p</italic>=0.22). TIs accounted for 6.4% of potential time on ART pre-2006 and 1.2% from 2006 (<italic>p</italic><0.01), and LTFU 4.7% of potential time on ART pre-2006 and 6.6% from 2006 (<italic>p</italic><0.01). Median TI duration was 163 (IQR: 75–391) days pre-2006 and 118 (IQR: 67–270) days from 2006 (<italic>p</italic><0.01). Independent risk factors for the first TI were: Australia HIV Observational Database participation; ART initiation pre-2006; ART regimens including stavudine and didanosine; three nucleoside analogue reverse transcriptase inhibitors; ≥7 pills per day; and ART with food restrictions (fasting or with food). In conclusion, since 2006, 7.8% of patients had significant time off treatment, which has the potential to compromise any ‘test and treat’ policy as during the interruption viral load will rebound and increase the risk of transmission.</p></abstract><counts><fig-count count="2"></fig-count><table-count count="4"></table-count><ref-count count="47"></ref-count><page-count count="11"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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