Cohort of HIV Infected Adults and Children

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Antiretroviral therapy has been shown to have dramatic impact on reducing the risk of progression to AIDS and death in HIV-infected adults and children in clinical trials. Large observational cohorts in Europe and the US demonstrated the impact of antiretroviral therapy on mortality in HIV-infected patients in routine care settings, with up to 70% reductions in risk of death.

PHPT has been working within public hospitals to provide treatment for the participants of the research studies and other people living with HIV/AIDS throughout Thailand with support from the Thai Ministry of Public Health, Oxfam GB and the Global Fund. All patients in this treatment cohort are monitored to ensure their safety and to examine the efficacy and impact of the treatment provided.

To ensure optimal use of antiretrovirals and durability of drug regimens, the program highlights the critical importance of active involvement of People Living with HIV/AIDS, the need for hands-on training of medical professionals and the benefits of establishing independent networks of HIV care specialists.  The development of clear procedures for patient screening, clinical and biological evaluations and systematic data collection enabled the program to document the high rate of virological and immunological success and low rate of mortality achieved. 

This cohort is closely monitored with regular clinical and demographic data collection.  Data is analysed to address the following key research areas to inform future policies and programs to optimize benefits of antiretroviral therapy:
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• Long term efficacy of antiretroviral therapy: long term survival, factors associated with survival, immunological and virologic response
• Antiretroviral Safety: incidence and risk factors to toxicities, incidence of hospitalisation/serious adverse events (HIV related, ARV related, others)
• Drug resistance: durability of first line regimen and patterns of resistance, resistance mutations at baseline.
• Coinfections: HIV and Hepatitis B, Hepatitis C and Tuberculosis
• Adherence to therapy
• Cost effectiveness of antiretroviral treatment: diagnosis strategies (paediatric), treatment regimens, monitoring strategies.

Through ongoing training and development of specific clinical procedures, the program will continue to strengthen HIV care teams and their collaboration with people living with HIV/AIDS.

For further information please refer to: ClinicalTrials.gov NCT00433030