Monitoring HIV Drug Resistance: Early Warning Indicators to Assess Performance of Thailand’s Antiretroviral Treatment Program

Details

• Alternative Title:
  J Med Assoc Thai
• Personal Author:
  Lertpiriyasuwat, Cheewanan ; Teeraratkul, Achara ; Suchonwanich, Yolsilp ; Chatharojwong, Nartlada ; Phokasawad, Kunjanakorn ; Yuktanon, Porntip ; Pattarapayoon, Naparat ; Bhakeecheep, Sorakij ; Bertagnolio, Silvia ; Roels, Thierry H ; Thanprasertsuk, Sombat
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• Description:
  Objective ; To describe trends in Thailand’s antiretroviral treatment (ART) program performance assessed by HIV drug resistance early warning indicators (EWIs), as recommended by WHO, between 2009 and 2013. ; Material and Method ; Seven EWIs were monitored, viral load (VL) testing coverage, VL suppression, retention in ART, lost to follow-up (LTFU), antiretrovirals (ARVs) dispensing practices, on-time pill pick-up, and pharmacy stock-outs. Data from ART adult patients in National Health Security Office Scheme were analyzed except for pharmacy stock-outs, which were reported from hospitals. Aggregated averages were calculated for each EWI. Chi-square for trend was applied to measure significant changes. ; Results ; By September 2013, 174,284 adults were receiving ART at 929 hospitals. Over time, improvement in VL testing coverage (53.8% in 2009 to 79.8% in 2013) was observed. VL suppression and on-time pill pick up rates were well above 90%. Rates of retention in ART declined from 84.0 to 82.9%, whereas LTFU rates increased from 8.3 to 9.2% (p<0.001). Prescriptions with inappropriate ARVs decreased from 0.32 to 0.10% (p<0.001). Of reporting hospitals, 96.1%, 96.3%, and 96.2% observed no ARVs stock-out between 2011 and 2013. ; Conclusion ; EWI is a useful tool to monitor ART program performance and to identify area where improvement is needed.
• Subjects:
  • Article
  • HIV
  • Drug resistance
  • Early warning indicator
  • Antiretroviral treatment
  • Thailand
  • Adolescent
  • Adult
  • Anti-Retroviral Agents
  • Drug Resistance, Viral
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• Source:
  J Med Assoc Thai. 100(9):944-952
• Pubmed ID:
  29861515
• Pubmed Central ID:
  PMC5978419
• Document Type:
  Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U2G GH000616/GH/CGH CDC HHSUnited States/
• Volume:
  100
• Issue:
  9
• Download URL:
  https://stacks.cdc.gov/view/cdc/55663/cdc_55663_DS1.pdf
• File Type:
  [PDF - 90.92 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:760465788e8e42b8a2197ac16c2ccbcd14a15c93514579b75da3b6e0ec5a1c40