Table 4.
Third-line regimen patient characteristics and early outcomes on third-line ART
| Characteristic at start of third-line | Total (n = 82) |
Switched to third-line (n = 36) |
Transferred in on third-line ART (n = 46) |
|
|---|---|---|---|---|
| Gender | N, % | |||
| Male | 31/82 (37.8%) | 12/36 (33.3%) | 19/46 (41.3%) | |
| Female | 51/82 (62.2%) | 24/36 (66.7%) | 27/46 (58.7%) | |
| Age, years | Median, IQR | 40.0 (35.5–47.3) | 40.0 (35.2–46.8) | 40.0 (36.2–47.3) |
| 18–30 | N, % | 5/82 (6.1%) | 4/36 (11.1%) | 1/82 (2.2%) |
| 30–45 | 52/82 (63.4%) | 20/36 (55.6%) | 32/82 (69.6%) | |
| ≥ 45 | 25/82 (30.5%) | 12/36 (33.3%) | 13/82 (28.3%) | |
| CD4 count closest to start of third-line ART, cells/mm3 | Median, IQR N, % |
277.0 (194.0–439.0) | 263.0 (156.0–390.0) | 339.0 (212.0–472.0) |
| < 100 | 9/58 (15.5%) | 5/27 (18.5%) | 4/31 (12.9%) | |
| 100–200 | 6/58 (13.7%) | 3/27 (11.1%) | 3/31 (9.7%) | |
| 200–350 | 21/58 (32.9%) | 12/27 (44.4%) | 9/31 (29.0%) | |
| ≥ 350 | 22/58 (35.6%) | 7/27 (25.9%) | 15/31 (48.4%) | |
| Missing | 24/82 | 9/36 | 15/46 | |
| Third-line regimen | N, % | |||
| DRV/r + RAL + ETV | 0/82 (0.0%) | 0/36 (0.0%) | 0/46 (0.0%) | |
| DRV/r + RAL | 17/82 (20.7%) | 11/36 (30.6%) | 6/46 (13.0%) | |
| RAL + ETV | 0/82 (0.0%) | 0/36 (0.0%) | 0/46 (0.0%) | |
| DRV/r + ETV | 5/82 (6.1%) | 2/36 (5.6%) | 3/46 (6.5%) | |
| DRV/r | 30/82 (36.6%) | 12/36 (33.3%) | 18/46 (39.1%) | |
| RAL | 18/82 (22.0%) | 4/36 (11.1%) | 14/46 (30.4%) | |
| ETV | 12/82 (14.6%) | 7/36 (19.4%) | 5/46 (10.9%) | |
| NRTI backbone | ||||
| TDF | 31/82 (37.8%) | 13/36 (36.1%) | 18/46 (39.1%) | |
| AZT | 4/82 (4.9%) | 1/36 (2.8%) | 3/46 (6.5%) | |
| ABC | 0/82 (0.0%) | 0/36 (0.0%) | 0/46 (0.0%) | |
| TDF + AZT | 5/82 (6.1%) | 4/36 (11.1%) | 1/46 (2.2%) | |
| TDF + ABC | 0/82 (0.0%) | 0/36 (0.0%) | 0/46 (0.0%) | |
| Other | 42/82 (51.2%) | 18/36 (50.0%) | 24/46 (52.2%) | |
| Viral load closest to start of third-line ART, copies/mL (> 400 copies/mL) | Median, IQR N, % |
13,930.0 (2655.0–62,515.0) | 24,096.5 (3877.5–84,934.0) | 7883.0 (1504.0–41,485.0) |
| < 1000 | 11/73 (15.1%) | 3/36 (8.3%) | 8/37 (21.6%) | |
| 1000–50,000 | 40/73 (54.8%) | 20/36 (55.6%) | 20/37 (54.1%) | |
| ≥ 50,000 | 22/73 (30.1%) | 13/36 (36.1%) | 9/37 (24.3%) | |
| Missing | 9/82 | 0/36 | 9/46 | |
| Year starting third-line ART | N, % | |||
| 2012 | 20/82 (24.4%) | 3/36 (8.3%) | 17/46 (37.0%) | |
| 2013–2016 | 62/82 (75.6%) | 33/36 (91.7%) | 29/46 (63.0%) | |
| Time to first ever viral suppression on third-line | N, % | |||
| 1–6 months | 49/82 (59.8%) | 22/36 (61.1%) | 27/46 (58.7%) | |
| 6–12 months | 16/82 (19.5%) | 7/36 (19.4%) | 9/46 (19.6%) | |
| Missing | 17/82 (20.7%) | 7/36 (19.4%) | 10/61 (21.7%) | |
| Outcomes on third-line ART | ||||
| Viral suppression on third-line by first viral load within 6 months (early suppression) | N, % | |||
| Alive, in care and suppressed | 47/82 (57.3%) | 20/36 (55.6%) | 27/46 (58.7%) | |
| Alive, in care and not suppressed | 13/82 (15.9%) | 7/36 (19.4%) | 6/46 (13.0%) | |
| Alive, in care and no repeat viral load/no repeat viral load within follow-up | 17/82 (20.7%) | 7/36 (19.4%) | 10/46 (21.7%) | |
| Not alive or in care | ||||
| Died | 2/82 (2.4%) | 1/36 (2.8%) | 1/46 (2.2%) | |
| Loss to follow-up* | 0/82 (0.0%) | 0/36 (0.0%) | 0/46 (0.0%) | |
| Transfer-out | 3/82 (3.7%) | 1/36 (2.8%) | 2/46 (4.4%) | |
| Viral suppression on third-line by 12 months | N, % | |||
| Alive, in care and suppressed | 35/82 (42.7%) | 16/36 (44.4%) | 19/46 (41.3%) | |
| Alive, in care and not suppressed | 7/82 (8.5%) | 5/36 (13.9%) | 2/46 (4.4%) | |
| Alive, in care and no repeat viral load/no repeat viral load within follow-up | 30/82 (36.6%) | 12/36 (33.3%) | 18/46 (39.1%) | |
| Not alive or in care | ||||
| Died | 4/82 (4.9%) | 2/36 (5.6%) | 2/46 (4.4%) | |
| Loss to follow-up* | 1/82 (1.2%) | 0/36 (0.0%) | 1/46 (2.2%) | |
| Transfer-out | 5/82 (6.1%) | 1/36 (2.8%) | 4/46 (8.7%) | |
| Never suppressed viral load below 400 copies/mL by 12 months | N, % | 6/71 (8.5%) | 4/33 (12.1%) | 2/38 (5.3%) |
ABC abacavir; 3TC lamivudine; LPVr lopinavir ritonavir; TDF tenofovir; AZT zidovudine; ddI didanosine; d4T stavudine, ETR etravirine, RAL raltegravir, DRV/r ritonavir boosted darunavir, IQR interquartile range
* Loss to follow-up defined as missing their last scheduled visit ≥ 3 months