{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:40:39Z","timestamp":1790138439273,"version":"4.0.1"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the National Key R & D Program of China during the 14th Five-Year Plan Period","award":["2021ZD0114102"],"award-info":[{"award-number":["2021ZD0114102"]}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["71874100"],"award-info":[{"award-number":["71874100"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Beijing Municipal Science & Technology Commission","award":["D171100006717002"],"award-info":[{"award-number":["D171100006717002"]}]},{"name":"Incubation Fund of Vanke School of Public Health at Tsinghua University","award":["2021PY002"],"award-info":[{"award-number":["2021PY002"]}]},{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzen Municipality","doi-asserted-by":"publisher","award":["SZSM202111001"],"award-info":[{"award-number":["SZSM202111001"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Durability of the initially prescribed antiretroviral therapy (ART) regimen is critical for long-term virologic suppression among people living with human immunodeficiency virus (HIV). However, data on the incidence of regimen modification and its associated factors remain limited in China. We aim to quantify the incidence of initially prescribed ART modification and identify associated baseline factors in China. Treatment-na\u00efve adults (\u226518 years) who initiated ART with complete regimen records and have documented follow-up information in Beijing, China, from 2010 to 2020 were included. The primary outcome was initially prescribed ART regimen modification. A multivariable Cox proportional hazards model was applied to evaluate factors associated with modification risk. Of 18,911 participants included, 3,725 (19.7%) participants experienced ART modification over 472,565 person-months of follow-up (PMFU), a rate of 7.9 per 1,000 PMFU. The median follow-up was 32 (IQR 13\u201336) months. Modification rates peaked in months 0\u20136: TDF\u2009+\u2009AZT\u2009+\u2009NVP and LPV\/r\u2009+\u20093TC\u2009+\u2009AZT exhibited the highest 6-month modification rates (59.4 and 57.7 per 1,000 PMFU, respectively), whereas TDF\u2009+\u20093TC\u2009+\u2009EFV, the most prescribed regimen, had the lowest early switch rate (8.8 per 1,000 PMFU). In multivariable analysis, baseline white blood cell (WBC) &lt; 4.0\u2009\u00d7\u200910\u2079\/L and WHO stage II\u2013IV were associated with higher modification risk; missing baseline records of WBC, hepatitis B virus or hepatitis C virus coinfection, and later calendar year of ART initiation were associated with lower modification risk; compared to EFV\u2009+\u20093TC\u2009+\u2009TDF, LPV\/r\u2009+\u20093TC\u2009+\u2009AZT had the highest modification risk. TDF\u2009+\u20093TC\u2009+\u2009EFV was the predominant initially prescribed regimen with the highest durability, while LPV\/r\u2009+\u20093TC\u2009+\u2009AZT had the highest modification rate. These findings underscore the need for early ART initiation, comprehensive pretreatment screening, and enhanced early monitoring\u2014especially during the first six months\u2014to optimize regimen selection and minimize unnecessary modification.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005319","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:34:41Z","timestamp":1762194881000},"page":"e0005319","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of antiretroviral therapy regimen modification and associated factors among People Living with HIV in Beijing, China"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2382-1189","authenticated-orcid":true,"given":"Yuanqi","family":"Mi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9841-1456","authenticated-orcid":true,"given":"Xiaofei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peicheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0134-1232","authenticated-orcid":true,"given":"Mengge","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"pgph.0005319.ref001","unstructured":"UNAIDS. 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