Clinical characteristics and laboratory investigations of the 393 index HIV-infected patients.

<p>Clinical characteristics and laboratory investigations of the 393 index HIV-infected patients.</p

Clinical characteristics and laboratory investigations of the 393 partners.

<p>Clinical characteristics and laboratory investigations of the 393 partners.</p

Proportion of couples using condoms or abstaining from sex, stratified by the HIV serostatus of the partners.

<p>Proportion of couples using condoms or abstaining from sex, stratified by the HIV serostatus of the partners.</p

Proportion receiving antiretroviral therapy and outcomes of the index HIV-infected patients with serodiscordant, seroconcordant, and unknown HIV serostatus partners.

<p>Proportion receiving antiretroviral therapy and outcomes of the index HIV-infected patients with serodiscordant, seroconcordant, and unknown HIV serostatus partners.</p

Prevalence of HIV infection, access to HIV care, and response to antiretroviral therapy among partners of HIV-infected individuals in Thailand

<div><p>Background</p><p>Health care providers usually focus on index HIV-infected patients and seldom obtain information from their partners. We aimed to determine HIV-preventative measures among couples, the prevalence of HIV infection, and treatment outcomes of partners.</p><p>Methods</p><p>This cross-sectional study was conducted in two hospital settings, a university hospital in Bangkok and a general hospital in northeastern Thailand, from January 2011-October 2015. Factors associated with serodiscordant relationships were determined by logistic regression.</p><p>Results</p><p>A total of 393 couples were enrolled for analysis; 156 (39.7%) were serodiscordant. The median relationship duration of serodiscordant couples was shorter than that of seroconcordant couples (6.4 years vs 11.6 years, <i>p</i> < 0.001). Of 237 HIV-infected partners, 17.7% had AIDS-defining illness, the median nadir CD4 count (interquartile range) was 240 (96–427) cells/mm³, 83.5% received antiretroviral therapy (ART), 98.3% had adherence > 95%, 90.3% had undetectable HIV RNA, and 22.9% had a prior history of treatment failure. There was no significant difference in condom usage in the prior 30 days between serodiscordant and seroconcordant couples. Factors of index HIV-infected patients associated with serodiscordant relationships were younger age (odds ratio [OR] 1.04 per 5 years; 95% confidence interval [CI] 1.01–1.06), receiving care at the general hospital (OR 1.73; 95% CI 1.08–2.78), a shorter duration of relationship (OR 1.04 per year; 95% CI 1.01–1.07), a higher nadir CD4 count (OR 1.06 per 50 cells/mm³; 95% CI 1.1–1.13), and not receiving a protease inhibitor-based regimen (OR 2.04; 95% CI 1.06–3.96).</p><p>Conclusions</p><p>A high number of serodiscordant couples was determined. Partners’ information should be retrieved as a holistic approach. Interventions for minimizing HIV transmission within serodiscordant couples should be evaluated and implemented.</p></div

Baseline Characteristics, Patients Who Received Placebo First Compared to Those That Received Pitavastatin First.

<p>Baseline Characteristics, Patients Who Received Placebo First Compared to Those That Received Pitavastatin First.</p

Lipid Measurements, Patients Who Received Placebo First Compared to Those That Received Pitavastatin First.

<p>Lipid Measurements, Patients Who Received Placebo First Compared to Those That Received Pitavastatin First.</p

Study flowchart.

<p>^aadherence, adverse drug reaction, CD4 count, and HIV RNA; ^badherence < 95%, had adverse drug reaction, or detectable HIV RNA (> 200 copies/mL) in the prior 6 months; ^cHIV prevention and adherence counselling; repeated HIV RNA and/or HIV genotype (if HIV RNA > 1,000 copies/mL).</p

Cost-effectiveness analysis of HLA-B*13:01 screening for the prevention of co-trimoxazole-induced severe cutaneous adverse reactions among HIV-infected patients in Thailand

Studies found a strong association between HLA-B*13:01 allele and co-trimoxazole-induced severe cutaneous adverse reactions (SCARs). Genetic screening before initiation of co-trimoxazole may decrease the incidence of co-trimoxazole-induced SCARs. This study aims to evaluate the cost-effectiveness of HLA-B*13:01 screening before co-trimoxazole initiation in HIV-infected patients in Thailand. A combination of a decision tree model and a Markov model was used to estimate lifetime costs and outcomes of two strategies including 1) HLA-B*13:01 screening before co-trimoxazole initiation and 2) usual practice from a societal perspective. Alternative drugs are not considered because dapsone (the second-line drug) also presents a genetic risk. Input parameters were obtained from literature, government documents, and part of the TREAT Asia HIV Observational Database (TAHOD). One-way sensitivity analyses and probabilistic analyses were performed to determine robustness of the findings. HLA-B*13:01 screening resulted in 0.0061 quality-adjusted life years (QALYs) loss with an additional cost of 370 THB ($11.84). At the cost-effectiveness threshold of 160,000 THB ($5,112.85), the probability of the genetic screening strategy being cost-effective is 9.54%. This analysis demonstrated that HLA-B*13:01 allele screening before initiation of co-trimoxazole among HIV-infected patients is unlikely to be cost-effective in Thailand. Our findings will help policymakers make an evidence-informed decision making.</p

Flowchart of Subjects Participating in the Different Phases of Randomized Crossover Trial.

<p>Flowchart of Subjects Participating in the Different Phases of Randomized Crossover Trial.</p