{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T17:32:01Z","timestamp":1772299921411,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"European Union Framework Program 7"},{"name":"Wellcome Trust\/Department of Biotechnology India Alliance Senior Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Combination antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) has improved in efficacy, durability and tolerability. Virological efficacy studies in India are limited. We determined incidence and predictors of virological failure among patients initiating first\u2010line <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and described virological resuppression after confirmed failure, with the goal of informing national policy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Therapy\u2010na\u00efve patients initiated on first\u2010line <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> as per national guidelines were monitored every 3\u00a0months for adherence and virological response over 2\u00a0years. Genotyping on baseline samples was performed to assess primary drug resistance. Multivariate Cox regression analysis was used to assess predictors of virological failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Virological failure rate among 599 eligible patients was 10.7 failures per 100 person\u2010years. Cumulative failure incidence was 13.2% in the first year and 16.5% over 2\u00a0years. Patients initiated on tenofovir had a significantly lower rate of virological failure than those on stavudine or zidovudine (6.7 <jats:italic>vs<\/jats:italic>. 11.9 failures per 100 person\u2010years, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.013). Virological failure was independently associated with age &lt;40\u00a0years, mean adherence &lt;95%, non\u2010tenofovir\u2010containing regimens and presence of primary drug resistance. In a subset of 311 patients who were reassessed after treatment failure, 19% (11\/58) patients resuppressed their viral load to &lt;400 copies\/ml after confirmed virological failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results support the inclusion of tenofovir as first\u2010line <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> in resource\u2010limited settings and a role for regular adherence counselling and virological monitoring for enhanced treatment success. Detection of early virological failure should provide an opportunity to augment adherence counselling and repeat viral load testing before therapy switch is considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12563","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T16:03:30Z","timestamp":1435939410000},"page":"1462-1472","source":"Crossref","is-referenced-by-count":22,"title":["Virological efficacy with first\u2010line antiretroviral treatment in India: predictors of viral failure and evidence of viral resuppression"],"prefix":"10.1111","volume":"20","author":[{"given":"Anita","family":"Shet","sequence":"first","affiliation":[{"name":"Department of Pediatrics St. John's Medical College Hospital Bangalore India"},{"name":"Division of Global Health Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ujjwal","family":"Neogi","sequence":"additional","affiliation":[{"name":"Division of Clinical Microbiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Kumarasamy","sequence":"additional","affiliation":[{"name":"YRG Center for AIDS Research and Education Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"DeCosta","sequence":"additional","affiliation":[{"name":"Division of Global Health Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Shastri","sequence":"additional","affiliation":[{"name":"National AIDS Control Organization Department of AIDS Control Ministry of Health and Family Welfare Government of India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharat Bhushan","family":"Rewari","sequence":"additional","affiliation":[{"name":"National AIDS Control Organization Department of AIDS Control Ministry of Health and Family Welfare Government of India New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67022-5"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1230413"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0956462414525769"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/497267"},{"key":"e_1_2_6_6_1","unstructured":"UNAIDS.World AIDS Day report 2012. 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