{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:45:48Z","timestamp":1793144748989,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Viral load (VL) testing is still challenging to monitor treatment responses of antiretroviral therapy (ART) for HIV treatment programme in Asia. We assessed the association between routine VL testing and virological failure (VF) and determine factors associated with switching to second\u2010line regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 21 sites from the TREAT Asia HIV Observational Database (TAHOD), people living with HIV (PLHIV) aged \u226518 years initiating ART from 2003 to 2021 were included. We calculated the average number of VL tests per patient per year between the date of ART initiation and the most recent visit. If the median average number of VL tests was \u2265 0.80 per patient per year, the site was classified as a routine VL site. A site with a median &lt; 0.80 was classified into the non\u2010routine VL sites. VF was defined as VL \u22651000 copies\/ml during first\u2010line therapy. Factors associated with VF were analysed using generalized estimating equations with Poisson distribution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 6277 PLHIV starting ART after 2003, 3030 (48%) were from 11 routine VL testing sites and 3247 (52%) were from 10 non\u2010routine VL testing sites. The median follow\u2010up was 9 years (IQR 5\u201313). The median age was 35 (30\u201342) years; 68% were male and 5729 (91%) started non\u2010nucleoside reverse\u2010transcriptase inhibitor\u2010based regimen. The median pre\u2010ART CD4 count in PLHIV from routine VL sites was lower compared to non\u2010routine VL sites (144 vs. 156 cells\/mm<jats:sup>3<\/jats:sup>, <jats:italic>p<\/jats:italic> &lt;0.001). Overall, 1021 subsequent VF at a rate of 2.15 (95% CI 2.02\u20132.29) per 100 person\u2010years (PY). VF was more frequent at non\u2010routine VL sites (adjusted incidence rate ratio 2.85 [95% CI 2.27\u20133.59]) compared to routine VL sites. Other factors associated with an increased rate of VF were age &lt;50 years and CD4 count &lt;350 cells\/mm<jats:sup>3<\/jats:sup>. A total of 817 (13%) patients switched to second\u2010line regimen at a rate of 1.44 (95% CI 1.35\u20131.54) per 100 PY. PLHIV at routine VL monitoring sites were at higher risk of switching than those at non\u2010routine VL sites (adjusted sub\u2010hazard ratio 1.78 95% CI [1.17\u20132.71]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PLHIV from non\u2010routine VL sites had a higher incidence of persistent VF and a low switching regimen rate, reflecting possible under\u2010utilized VL testing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25989","type":"journal-article","created":{"date-parts":[[2022,8,27]],"date-time":"2022-08-27T03:22:35Z","timestamp":1661570555000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Virological failure and treatment switch after ART initiation among people living with HIV with and without routine viral load monitoring in Asia"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9100-2930","authenticated-orcid":false,"given":"Sirinya","family":"Teeraananchai","sequence":"first","affiliation":[{"name":"Department of Statistics Faculty of Science Kasetsart University  Bangkok Thailand"},{"name":"HIV\u2010NAT, Thai Red Cross AIDS Research Centre  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Law","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5951-4503","authenticated-orcid":false,"given":"David","family":"Boettiger","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole De La","family":"Mata","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Gupte","sequence":"additional","affiliation":[{"name":"BJ Government Medical College and Sassoon General Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun\u2010ting Lawrence","family":"Chan","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital  Kowloon Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thach Ngoc","family":"Pham","sequence":"additional","affiliation":[{"name":"National Hospital for Tropical Diseases  Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romanee","family":"Chaiwarith","sequence":"additional","affiliation":[{"name":"Chiang Mai University \u2010 Research Institute for Health Sciences  Chiang Mai Thailand"},{"name":"Division of Infectious Diseases and Tropical Medicine Department of Medicine Faculty of Medicine Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penh Sun","family":"Ly","sequence":"additional","affiliation":[{"name":"National Center for HIV\/AIDS, Dermatology &amp; STDs  Phnom Penh Cambodia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Jiun","family":"Chan","sequence":"additional","affiliation":[{"name":"Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4379-4704","authenticated-orcid":false,"given":"Sasisopin","family":"Kiertiburanakul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ramathibodi Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suwimon","family":"Khusuwan","sequence":"additional","affiliation":[{"name":"Chiangrai Prachanukroh Hospital  Chiang Rai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6386-9879","authenticated-orcid":false,"given":"Fujie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Ditan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6650-0559","authenticated-orcid":false,"given":"Evy","family":"Yunihastuti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Indonesia \u2010 Dr. Cipto Mangunkusumo General Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagalingeswaran","family":"Kumarasamy","sequence":"additional","affiliation":[{"name":"Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS) VHS\u2010Infectious Diseases Medical Centre, VHS  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4571-650X","authenticated-orcid":false,"given":"Sanjay","family":"Pujari","sequence":"additional","affiliation":[{"name":"Institute of Infectious Diseases  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iskandar","family":"Azwa","sequence":"additional","affiliation":[{"name":"University Malaya Medical Centre  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I Ketut Agus","family":"Somia","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Udayana University &amp; 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