{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:56:53Z","timestamp":1753869413256,"version":"3.41.2"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,9]],"date-time":"2019-06-09T00:00:00Z","timestamp":1560038400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007554","name":"AIDS Life","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007554","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001027","name":"Department of Health and Ageing, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","award":["U01AI069907"],"award-info":[{"award-number":["U01AI069907"]}],"id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,6]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>Recommendations on the optimal frequency of plasma viral load (pVL<\/jats:styled-content>) monitoring in children living with HIV<\/jats:styled-content> (CLWH<\/jats:styled-content>) who are stable on combination antiretroviral therapy (cART<\/jats:styled-content>) are inconsistent. This study aimed to determine the impact of annual versus semi\u2010annual pVL<\/jats:styled-content> monitoring on treatment outcomes in Asian CLWH.<\/jats:p><\/jats:sec>Methods<\/jats:title>Data on children with perinatally acquired HIV<\/jats:styled-content> aged <18\u00a0years on first\u2010line, non\u2010nucleoside reverse transcriptase inhibitor\u2010based cART<\/jats:styled-content> with viral suppression (two consecutive pVL<\/jats:styled-content> <400\u00a0copies\/mL<\/jats:styled-content> over a six\u2010month period) were included from a regional cohort study; those exposed to prior mono\u2010 or dual antiretroviral treatment were excluded. Frequency of pVL<\/jats:styled-content> monitoring was determined at the site\u2010level based on the median rate of pVL<\/jats:styled-content> measurement: annual 0.75 to 1.5, and semi\u2010annual >1.5 tests\/patient\/year. Treatment failure was defined as virologic failure (two consecutive pVL<\/jats:styled-content> >1000\u00a0copies\/mL<\/jats:styled-content>), change of antiretroviral drug class, or death. Baseline was the date of the second consecutive pVL<\/jats:styled-content> <400\u00a0copies\/mL<\/jats:styled-content>. Competing risk regression models were used to identify predictors of treatment failure.<\/jats:p><\/jats:sec>Results<\/jats:title>During January 2008 to March 2015, there were 1220 eligible children from 10 sites that performed at least annual pVL<\/jats:styled-content> monitoring, 1042 (85%) and 178 (15%) were from sites performing annual (n\u00a0=\u00a06) and semi\u2010annual pVL<\/jats:styled-content> monitoring (n\u00a0=\u00a04) respectively. Pre\u2010cART<\/jats:styled-content>, 675 children (55%) had World Health Organization clinical stage 3 or 4, the median nadir CD<\/jats:styled-content>4 percentage was 9%, and the median pVL<\/jats:styled-content> was 5.2 log10<\/jats:sub> copies\/mL<\/jats:styled-content>. At baseline, the median age was 9.2\u00a0years, 64% were on nevirapine\u2010based regimens, the median cART<\/jats:styled-content> duration was 1.6\u00a0years, and the median CD<\/jats:styled-content>4 percentage was 26%. Over the follow\u2010up period, 258 (25%) CLWH<\/jats:styled-content> with annual and 40 (23%) with semi\u2010annual pVL<\/jats:styled-content> monitoring developed treatment failure, corresponding to incidence rates of 5.4 (95% CI<\/jats:styled-content>: 4.8 to 6.1) and 4.3 (95% CI<\/jats:styled-content>: 3.1 to 5.8) per 100 patient\u2010years of follow\u2010up respectively (p\u00a0<\/jats:italic>=\u00a0<\/jats:italic>0.27). In multivariable analyses, the frequency of pVL<\/jats:styled-content> monitoring was not associated with treatment failure (adjusted hazard ratio: 1.12; 95% CI<\/jats:styled-content>: 0.80 to 1.59).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Annual compared to semi\u2010annual pVL<\/jats:styled-content> monitoring was not associated with an increased risk of treatment failure in our cohort of virally suppressed children with perinatally acquired HIV<\/jats:styled-content> on first\u2010line NNRTI<\/jats:styled-content>\u2010based cART<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25312","type":"journal-article","created":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T06:33:20Z","timestamp":1560148400000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of the frequency of plasma viral load monitoring on treatment outcomes among children with perinatally acquired HIV<\/scp>"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-4623","authenticated-orcid":false,"given":"Tavitiya","family":"Sudjaritruk","sequence":"first","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine Chiang Mai University Chiang Mai Thailand"},{"name":"Research Institute for Health Sciences Chiang Mai University Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C","family":"Boettiger","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Australia Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lam Van","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Hospital of Pediatrics Hanoi Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thahira J","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Pediatric Institute, Hospital Kuala Lumpur Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dewi K","family":"Wati","sequence":"additional","affiliation":[{"name":"Sanglah Hospital Udayana University Bali Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsak","family":"Bunupuradah","sequence":"additional","affiliation":[{"name":"HIV\u2010NAT The Thai Red Cross AIDS Research Centre Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rawiwan","family":"Hansudewechakul","sequence":"additional","affiliation":[{"name":"Chiangrai Prachanukroh Hospital Chiang Rai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penh S","family":"Ly","sequence":"additional","affiliation":[{"name":"National Centre for HIV\/AIDS, Dermatology and STDs Phnom Penh Cambodia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pagakrong","family":"Lumbiganon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Revathy A","family":"Nallusamy","sequence":"additional","affiliation":[{"name":"Penang Hospital Penang Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moy S","family":"Fong","sequence":"additional","affiliation":[{"name":"Hospital Likas Kota Kinabalu Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kulkanya","family":"Chokephaibulkit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nik K","family":"Nik Yusoff","sequence":"additional","affiliation":[{"name":"Hospital Raja Perempuan Zainab II Kelantan Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khanh H","family":"Truong","sequence":"additional","affiliation":[{"name":"Children's 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