Table 2:
Follow-up status and cumulative incidence of switch by 3 years after start of ART by geographical region
| USA (n=192) | Latin America (n=926) | Europe (n=2142) | Asia (n=6107) | Southern Africa (n=17 857) | Rest of sub-Saharan Africa (n=66 127) | Overall (n=93 351) | |
|---|---|---|---|---|---|---|---|
| Follow-up* | |||||||
| Median (IQR), months | 41 (23–79) | 52 (24–93) | 49 (23–81) | 38 (17–69) | 29 (12–58) | 24 (8–47) | 26 (9–52) |
| Switched to second-line ART | 72 (37·5%) | 123 (13·3%) | 464 (21·7%) | 587 (9·6%) | 1255 (7·0%) | 1382 (2·1%) | 3883 (4·2%) |
| Died | 0 | 4 (0·4%) | 3 (0·1%) | 31 (0·5%) | 17 (0·1%) | 394 (0·6%) | 449 (0·5%) |
| Lost to follow-up | 15 (7·8%) | 214 (23·1%) | 235 (11·0%) | 674 (11·0%) | 3446 (19·3%) | 13 688 (20·7%) | 18 272 (19·6%) |
| Administrative censoring | 105 (54·7%) | 585 (63·2%) | 1440 (67·2%) | 4815 (78·8%) | 13 139 (73·6%) | 50 663 (76·6%) | 70 747 (75·8%) |
| Cumulative incidence switched by 3 years after start of ART | |||||||
| Overall | 26·1% (20·0–32·7) | 6·5% (4·9–8·3) | 12·2% (10·8–13·7) | 6·6% (5·9–7·3) | 5·4% (5·1–5·9) | 1·5% (1·4–1·6) | 3·1% (3·0–3·2) |
| Age at initiation of ART, years | |||||||
| <3 years | 25·7% (18·5–33·4) | 4·9% (2·9–7·6) | 11·7% (9·8–13·9) | 7·0% (5·8–8·3) | 3·7% (3·2–4·2) | 1·1% (0·9–1·2) | 2·5% (2·3–2·7) |
| 3–5 | 27·6% (13·7–43·3) | 5·0% (2·7–8·5) | 8·9% (6·4–12·0) | 7·0% (5·8–8·4) | 6·5% (5·7–7·4) | 1·4% (1·2–1·6) | 3·1% (2·9–3·4) |
| 6–9 | 27·1% (9·8–48·0) | 8·3% (5·1–12·4) | 14·8% (11·5–18·4) | 5·6% (4·5–6·9) | 7·2% (6·3–8·1) | 2·0% (1·8–2·3) | 3·7% (3·4–4·0) |
| ≥10 | ·· | 12·3% (5·7–21·6) | 16·6% (11·5–22·5) | 6·7% (2·7–13·5) | 6·7% (4·5–9·5) | 2·4% (1·7–3·4) | 4·9% (4·0–5·9) |
| Initial ART regimen | |||||||
| Protease inhibitor based | 10·1% (4·4–18·5) | 5 ·1% (1·6–11·6) | 7·0% (5·4–8·8) | 3·6% (1·6–7·1) | 3·2% (2·7–3·7) | 4·3% (3·2–5·7) | 3·9% (3·4–4·3) |
| NNRTI based | 37·0% (28·1–45·9) | 6·6% (5·0–8·5) | 16·1% (14·0–18·4) | 6·6% (5·9–7·4) | 7·0% (6·4–7·6) | 1·4% (1·3–1·5) | 3·0% (2·9–3·2) |
| Monitoring strategy | |||||||
| Routine CD4 and viral load | 26·1% (20·0–32·7) | 7·7% (5·3–10·7) | 12·3% (10·8–13·8) | 8·7% (7·8–9·8) | 5·4% (5·1–5·9) | 6·1% (5·0–7·4) | 6·8% (6·5–7·2) |
| Routine CD4 and targeted viral load | ·· | ·· | 5·9% (0·4–23·5) | 2·8% (2·0–3·7) | ·· | 2·1% (1·8–2·4) | 2·2% (1·9–2·4) |
| Routine CD4 only | ·· | 5·5% (3·6–7·9) | ·· | 3·5% (1·1–8·3) | ·· | 1·1% (1·0–1·3) | 1·2% (1·1–1·4) |
| Clinical only | ·· | ·· | ·· | ·· | ·· | 0·8% (0·6–1·0) | 0·8% (0·6–1·0) |
Data are n (%) or cumulative incidence (95% CI), unless otherwise indicated. ART=antiretroviral therapy. NNRTI=non-nucleoside reverse-transcriptase inhibitor.
*
Competing risk analysis, censored at the first of the following events: switched to second-line, death, loss to follow-up or date of last clinic visit (before transfer out or data cutoff).