Incidence Rate and Factors Associated with Antiretroviral Therapy Regimen Change among Adult HIV Patients at Ngoerah Hospital Bali, Indonesia.
- 1Division of Tropical and Infectious Diseases, Department of Medicine, Ngoerah Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. [email protected].
- 2Division of Tropical and Infectious Diseases, Department of Medicine, Ngoerah Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia.
- 3Department of Internal Medicine, Udayana University Academic Hospital, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.
Abstract
Background
The human immunodeficiency virus (HIV) epidemic remains a major global health concern. While antiretroviral therapy (ART) has significantly improved survival rates, regimen changes during long-term treatment are common and may impact clinical outcomes. Data regarding the incidence rate and determinants of ART regimen changes among people living with HIV (PLHIV) in Bali, Indonesia, remain limited.Material and methods
This retrospective cohort study included adult PLHIV receiving ART at Ngoerah Hospital, Bali, Indonesia, from July 2004 to December 2023. A total of 265 eligible patients were selected through systematic random sampling. Multivariable Cox Regression was used to identify factors associated with regimen change.Results
During the study period, the incidence rate of ART regimen changes was 2.22 per 100 person-years (95% confidence interval [CI], 1.760-2.802), with 3,196.7 person-years of observation, and the median follow-up duration for patients was 11.7 years (interquartile range, 11.1-13.7). The median age was 45 years, and the majority were male (64.5%). In multivariate analysis, nevirapine (NVP)-based initial regimens (adjusted hazard ratio [aHR], 1.853; 95% CI, 1.031-3.329; P=0.039) and baseline CD4 < 200 cells/µL (aHR, 1.940; 95% CI, 1.215-3.098; P=0.005) were significantly associated with regimen change. In addition, most regimen changes (87.3%) occurred after more than ten years of treatment. The primary reasons for regimen change were treatment failure (36.6%), medication stockout (23.9%), and adverse effects (21.1%).Conclusion
NVP-based regimens and low baseline CD4 counts were key factors of regimen change. Continuous monitoring, timely detection of treatment failure, and the use of more durable regimens are essential to improve long-term treatment outcomes for the HIV patients in our outpatient clinic in Bali, Indonesia.
Related
- Factors associated with mortality among critically ill pediatric patients referred to a tertiary hospital in Indonesia
- The impact of the SYNTAX score on the incidence of in-hospital cardiac arrest in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a retrospective cohort study
- Adherence of HIV/AIDS patients following Medication Therapy Management and Pharmacist Counselling at a Public Hospital in Yogyakarta, Indonesia
- Factors associated with prolonged hospital stay in mandibular condylar fractures: a multicenter retrospective study in Indonesia.
- High Initiation but Suboptimal Completion of Tuberculosis-Preventive Treatment Among People Living With HIV on Antiretroviral Therapy, Persistent Tuberculosis Incidence, and Programmatic Implications: Findings From a 2-Year Multicountry Cohort Study
BibTeX
@article{somia2026incidence,
title = {{Incidence Rate and Factors Associated with Antiretroviral Therapy Regimen Change among Adult HIV Patients at Ngoerah Hospital Bali, Indonesia.}},
author = {I Ketut Agus Somia and I Made Susila Utama and Anak Agung Ayu Yuli Gayatri and Ni Made Dewi Dian Sukmawati and Cokorda Agung Wahyu Purnamasidhi},
journal = {Infection \& chemotherapy},
year = {2026},
month = sep,
doi = {10.3947/ic.2026.0006},
url = {https://europepmc.org/article/MED/42847628},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Incidence Rate and Factors Associated with Antiretroviral Therapy Regimen Change among Adult HIV Patients at Ngoerah Hospital Bali, Indonesia.
AU - I Ketut Agus Somia
AU - I Made Susila Utama
AU - Anak Agung Ayu Yuli Gayatri
AU - Ni Made Dewi Dian Sukmawati
AU - Cokorda Agung Wahyu Purnamasidhi
PY - 2026
DA - 2026/09/01
JO - Infection & chemotherapy
DO - 10.3947/ic.2026.0006
UR - https://europepmc.org/article/MED/42847628
AB - Background The human immunodeficiency virus (HIV) epidemic remains a major global health concern. While antiretroviral therapy (ART) has significantly improved survival rates, regimen changes during long-term treatment are common and may impact clinical outcomes. Data regarding the incidence rate and determinants of ART regimen changes among people living with HIV (PLHIV) in Bali, Indonesia, remain limited.Material and methods This retrospective cohort study included adult PLHIV receiving ART at Ngoerah Hospital, Bali, Indonesia, from July 2004 to December 2023. A total of 265 eligible patients were selected through systematic random sampling. Multivariable Cox Regression was used to identify factors associated with regimen change.Results During the study period, the incidence rate of ART regimen changes was 2.22 per 100 person-years (95% confidence interval [CI], 1.760-2.802), with 3,196.7 person-years of observation, and the median follow-up duration for patients was 11.7 years (interquartile range, 11.1-13.7). The median age was 45 years, and the majority were male (64.5%). In multivariate analysis, nevirapine (NVP)-based initial regimens (adjusted hazard ratio [aHR], 1.853; 95% CI, 1.031-3.329; P=0.039) and baseline CD4 < 200 cells/µL (aHR, 1.940; 95% CI, 1.215-3.098; P=0.005) were significantly associated with regimen change. In addition, most regimen changes (87.3%) occurred after more than ten years of treatment. The primary reasons for regimen change were treatment failure (36.6%), medication stockout (23.9%), and adverse effects (21.1%).Conclusion NVP-based regimens and low baseline CD4 counts were key factors of regimen change. Continuous monitoring, timely detection of treatment failure, and the use of more durable regimens are essential to improve long-term treatment outcomes for the HIV patients in our outpatient clinic in Bali, Indonesia.
SN - 2093-2340
SN - 2092-6448
ER -