Table 3.
Timing of Switch to Second-Line Antiretroviral Treatment Among Patients With Human Immunodeficiency Virus Virologic Failure by Type of Viral Load Test
| VL Test | ID | Initial Regimen | 6-Month VL (Copies/mL) | Timing of 6-Month VL (Months) | Confirmatory VL (Copies/mL) | Timing of Confirmatory VL (Months) | Antiretroviral Treatment Regimen at Switch or Second VL | Patient Switched to Second-Line Regimen? | Time to Switch (Days) |
|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||
| POC | 1 | TDF-3TC-EFV | 175 598 | 5.6 | 74 228 | 9.3 | TDF-3TC-ATV/r | Yes | 28 |
| 2 | TDF-3TC-EFV | 79 462 | 5.7 | 229 000 | 8.5 | TDF-3TC-ATV/r | Yes | 0 | |
| 3 | TDF-3TC-EFV | 1 170 000 | 5.8 | 866 000 | 8.5 | TDF-3TC-ATV/r | Yes | 0 | |
| 4 | TDF-3TC-EFV | 218 000 | 6.7 | 139 000 | 10.3 | TDF-3TC-ATV/r | Yes | 0 | |
| 5 | TDF-3TC-EFV | 3180 | 5.8 | 8280 | 11.6 | TDF-3TC-ATV/r | Yes | 0 | |
| 6 | TDF-3TC-EFV | 170 000 | 5.5 | 209 000 | 14.5 | AZT-3TC-ATV/r | Yes | 0 | |
| 7 | TDF-3TC-EFV | 5050 | 5.5 | 12 900 | 8.3 | TDF-3TC-LPV/r | Yes | 56 | |
| 8 | TDF-3TC-EFV | 9900 | 6.7 | 9009 | 9.4 | TDF-3TC-LPV/r | Yes | 7 | |
| POC | 9 | TDF-3TC-EFV | 166 000 | 6.7 | 1450 | 11.3 | TDF-3TC-DTG | No | … |
| SOC | 10 | TDF-3TC-EFV | 686 778 | 5.7 | 848 030 | 10.3 | TDF-3TC-ATV/r | Yes | 63 |
| 11 | TDF-3TC-EFV | 161 592 | 5.5 | 521 449 | 11.3 | TDF-3TC-ATV/r | Yes | 140 | |
| 12 | TDF-3TC-EFV | 289 463 | 5.5 | 173 728 | 12.0 | TDF-3TC-ATV/r | Yes | 123 | |
| 13 | TDF-3TC-EFV | 80 850 | 6.0 | 3 567 568 | 12.9 | TDF-3TC-LPV/r | Yes | 66 | |
| 14 | TDF-3TC-EFV | 2042 | 5.8 | 161 124 | 13.8 | TDF-3TC-ATV/r | Yes | 0 | |
| SOC | 15 | TDF-3TC-EFV | 284 597 | 6.0 | 445 503 | 8.8 | TDF-3TC-EFV | No | … |
| 16 | TDF-3TC-EFV | 2841 | 6.5 | 24 039 | 11.8 | TDF-3TC-EFV | No | … | |
| 17 | TDF-3TC-EFV | 670 742 | 6.7 | 121 164 | 11.8 | TDF-3TC-EFV | No | … | |
Median days from confirmed failure to switch to second-line antiretroviral treatment for POC patients 1–8 was 0 (interquartile range [IQR], 0–18), while median days to switch for SOC patients 10–14 was 66 (IQR, 63–123). By using the Wilcoxon Mann-Whitney test, there was a significant difference between POC and SOC arms (P = .0256).
Abbreviations: 3TC, lamivudine; ATV-r, AZT, zidovudine; DTG, dolutegravir; EFV, efavirenz; LPV/r, lopinavir/ritonavir; POC, point of care (testing by Cepheid GeneXpert human immunodeficiency virus type 1 (HIV-1) viral load assay); SOC, standard of care (testing by Roche COBAS AmpliPrep/TaqMan [CAP/CTM] HIV-1 Test, v2.0); TDF, tenofovir; VL, viral load.