{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:07:50Z","timestamp":1777853270022,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Second Century Fund (C2F) Chulalongkorn University"},{"DOI":"10.13039\/100001117","name":"amfAR, The Foundation for AIDS Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>This study aimed to assess second-line antiretroviral therapy (ART) outcomes in a National HIV Treatment program. People living with HIV aged \u226518 years initiating first-line ART who switched to second-line protease inhibitor-based regimens from January 2008 to May 2019, with a minimum of 1-year follow-up were studied. The primary outcome was second-line treatment failure (two consecutive virological failure episodes (viral load \u22651000 copies\/mL)). Of 318,506 PLH initiating ART, 29,015 (9.1%) switched to second-line regimens after a median (IQR) ART duration of 1.63 (0.60-3.59) years. Lost to follow-up (LTFU) occurred in 5316 (18.3%) of whom 1376 (5%) remained LTFU and alive; 4606 (15.9%) died. Cumulative second-line failure incidence was 9.8% at 6 years, more common in females, younger PLH those with lower switch CD4 cell counts. Multidisciplinary, innovative support systems are needed to improve second-line treatment outcomes, particularly those relating to modifiable risk factors.<\/jats:p>","DOI":"10.1177\/23259582231220513","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T02:35:51Z","timestamp":1703039751000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Outcomes After Switching to Second-Line Anti-Retroviral Therapy: Results From the Thai National Treatment Program"],"prefix":"10.1177","volume":"22","author":[{"given":"Pupe","family":"Sudsila","sequence":"first","affiliation":[{"name":"Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirinya","family":"Teeraananchai","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Science, Kasetsart University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2630-5104","authenticated-orcid":false,"given":"Cheewanan","family":"Lertpiriyasuwat","sequence":"additional","affiliation":[{"name":"Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rattaphon","family":"Triamwichanon","sequence":"additional","affiliation":[{"name":"National Health Security Office, Nonthaburi, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivaporn","family":"Gatechompol","sequence":"additional","affiliation":[{"name":"HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Opass","family":"Putcharoen","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ploenchan","family":"Chetchotisakd","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Khon Kaen University, Srinagarind Hospital, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anchalee","family":"Avihingsanon","sequence":"additional","affiliation":[{"name":"HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-4525","authenticated-orcid":false,"given":"Stephen J","family":"Kerr","sequence":"additional","affiliation":[{"name":"Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"The Kirby Institute, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiat","family":"Ruxrungtham","sequence":"additional","affiliation":[{"name":"HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Centre of Excellence in Vaccine Research and Development (Chula VRC), and School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"bibr1-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060247"},{"key":"bibr2-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12421"},{"key":"bibr3-23259582231220513","unstructured":"WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection\u2014Recommendations for a public health approach. Accessed November 22, 2022. http:\/\/www.who.int\/hiv\/pub\/guidelines\/arv2013\/download\/en\/"},{"key":"bibr4-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000298"},{"key":"bibr5-23259582231220513","unstructured":"WHO. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. WHO. Accessed November 22, 2022. https:\/\/www.who.int\/hiv\/pub\/guidelines\/ARV2018update\/en\/"},{"key":"bibr6-23259582231220513","unstructured":"Ruxrungtham K, Chokephaibulkit K, Chetchotisakd P, et al.\n                      Thailand National Guidelines on HIV\/AIDS Treatment and Prevention 2021\/\n                      2022. 2022."},{"key":"bibr7-23259582231220513","unstructured":"WHO. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV. Accessed November 4, 2021. https:\/\/www.who.int\/hiv\/pub\/guidelines\/ARV2018update\/en\/"},{"key":"bibr8-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25989"},{"key":"bibr9-23259582231220513","unstructured":"WHO. Antiretroviral medicines in low- and middle-income countries: forecasts of global and regional demand for 2020-2024. 8 December 2022. https:\/\/www.who.int\/publications\/i\/item\/9789240041264"},{"key":"bibr10-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13006"},{"key":"bibr11-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1016\/S2055-6640(20)30323-X"},{"key":"bibr12-23259582231220513","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3233"},{"key":"bibr13-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1086\/430387"},{"key":"bibr14-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2008.07.007"},{"key":"bibr15-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002324"},{"key":"bibr16-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002901"},{"key":"bibr17-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271910"},{"key":"bibr18-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2010.00825.x"},{"key":"bibr19-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005790"},{"key":"bibr20-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0613-z"},{"key":"bibr21-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix015"},{"key":"bibr22-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.03.003"},{"key":"bibr23-23259582231220513","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328351f5b2"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582231220513","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582231220513","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582231220513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:50:18Z","timestamp":1777503018000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582231220513"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":23,"alternative-id":["10.1177\/23259582231220513"],"URL":"https:\/\/doi.org\/10.1177\/23259582231220513","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"23259582231220513"}}