Publications by authors named "Wing Wai Wong"
Background: The clinical utilisation of deep sequencing in HIV treatment has been hindered due to its unknown correlation with standard Sanger genotyping and the undetermined value of minority drug resistance mutation (DRM) detection.
Objectives: To compare deep sequencing performance to standard Sanger genotyping with clinical samples, in an effort to delineate the correlation between the results from the two methods and to find the optimal deep sequencing threshold for clinical utilisation.
Methods: We conducted a retrospective study using stored plasma collected from August 2014 to March 2018 for HIV genotyping with the commercial Sanger genotyping kit.
Background: Administration of a single broadly neutralizing human immunodeficiency virus (HIV)-specific antibody to HIV-infected persons leads to the development of antibody-resistant virus in the absence of antiretroviral therapy (ART). It is possible that monotherapy with UB-421, an antibody that blocks the virus-binding site on human CD4+ T cells, could induce sustained virologic suppression without induction of resistance in HIV-infected persons after analytic treatment interruption.
Methods: We conducted a nonrandomized, open-label, phase 2 clinical study evaluating the safety, pharmacokinetics, and antiviral activity of UB-421 monotherapy in HIV-infected persons undergoing analytic treatment interruption.
Introduction: Cotrimoxazole (CTX) is recommended as prophylaxis against Pneumocystis jiroveci pneumonia, malaria and other serious bacterial infections in HIV-infected patients. Despite its in vitro activity against Mycobacterium tuberculosis, the effects of CTX preventive therapy on tuberculosis (TB) remain unclear.
Methods: Adults living with HIV enrolled in a regional observational cohort in Asia who had initiated combination antiretroviral therapy (cART) were included in the analysis.
Background: Doravirine (DOR), a novel non-nucleoside reverse-transcriptase inhibitor (NNRTI), is active against wild-type Human Immunodeficiency Virus (HIV)-1 and the most common NNRTI-resistant variants, and has a favorable and unique in vitro resistance profile.
Methods: DRIVE-AHEAD is a phase 3, double-blind, non-inferiority trial. Antiretroviral treatment-naive adults with ≥1000 HIV-1 RNA copies/mL were randomized (1:1) to once-daily, fixed-dose DOR at 100 mg, lamivudine at 300 mg, and tenofovir disoproxil fumarate (TDF) at 300 mg (DOR/3TC/TDF) or to efavirenz at 600 mg, emtricitabine at 200 mg, and TDF at 300 mg (EFV/FTC/TDF) for 96 weeks.
Optimal timing for elective total hip replacement in HIV-positive patients.
Orthop Traumatol Surg Res
September 2018
Introduction: Evidence about the optimal timing for total hip replacement (THR) in HIV-positive patients is scant.
Hypothesis: Preoperative criteria: cluster of differentiation 4 (CD4) counts>200cells/mm and an undetectable HIV virus load before THR, improve infection rates, aseptic loosenings, and functional outcomes.
Materials And Methods: We recruited 16 HIV-positive patients who had undergone 25 THRs between 2003 and 2015.
Article Synopsis
- Cardiovascular diseases (CVD) are increasingly common among aging HIV-infected populations, particularly in Asia, where limited research has been conducted on their prevalence and management.
- Current studies indicate that CVD risk factors such as high cholesterol, diabetes, obesity, and smoking are prevalent in these populations, and HIV infection along with antiretroviral therapy may heighten this risk.
- To effectively address the growing CVD burden in HIV-positive individuals, there's a need for comprehensive guidelines that integrate CVD and HIV care, alongside research to develop better screening strategies and assess the future impact of CVD.
Article Synopsis
- The study evaluated the outcomes of antiretroviral regimen substitutions in virologically suppressed HIV-infected patients across Asian countries, focusing on non-clinical trial settings.
- It included 3,994 adults who started combination antiretroviral treatment after 2002, finding that 37.5% underwent minor and 9.5% underwent major regimen substitutions.
- Results showed varying rates of clinical or virological failure, with 1.48/100 person years for minor substitutions, 2.85/100 for major, and 2.53/100 for those without substitutions, indicating that both types of substitutions had differing impacts on patient outcomes.
Factors associated with pre-treatment HIV RNA: application for the use of abacavir and rilpivirine as the first-line regimen for HIV-infected patients in resource-limited settings.
AIDS Res Ther
March 2018
Background: Abacavir and rilpivirine are alternative antiretroviral drugs for treatment-naïve HIV-infected patients. However, both drugs are only recommended for the patients who have pre-treatment HIV RNA <100,000 copies/mL. In resource-limited settings, pre-treatment HIV RNA is not routinely performed and not widely available.
View Article and Find Full Text PDFIntroduction: Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries.
Methods: Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed.
Background: In resource-limited settings, routine monitoring of renal function during antiretroviral therapy (ART) has not been recommended. However, concerns for tenofovir disoproxil fumarate (TDF)-related nephrotoxicity persist with increased use.
Methods: We investigated serum creatinine (S-Cr) monitoring rates before and during ART and the incidence and prevalence of renal dysfunction after starting TDF by using data from a regional cohort of HIV-infected individuals in the Asia-Pacific.
Article Synopsis
- - The study explored the connection between elevated CD8 counts and the risk of virological failure (VF) in Asian HIV-infected patients starting combination antiretroviral therapy (cART), analyzing data from 2475 patients across 19 sites.
- - Results indicated that 27% of participants experienced VF within the first four years of cART, and recent elevated CD8 counts were linked to a higher risk of VF, suggesting a possible reactive rather than causal relationship.
- - The findings imply that CD8 levels could serve as an early warning sign for potential VF in patients on cART, but earlier CD8 measurements did not show a significant predictive value for future treatment outcomes.
Background: We assessed the effects of hepatitis B (HBV) or hepatitis C (HCV) co-infection on outcomes of antiretroviral therapy (ART) in HIV-infected patients enrolled in the TREAT Asia HIV Observational Database (TAHOD), a multi-center cohort of HIV-infected patients in the Asia-Pacific region.
Methods: Patients testing HBs antigen (Ag) or HCV antibody (Ab) positive within enrollment into TAHOD were considered HBV or HCV co-infected. Factors associated with HBV and/or HCV co-infection were assessed by logistic regression models.
Background: HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.
Method: This review seeks to redress the imbalance by promoting awareness and education among physicians concerning the neurovirulence of HIV and thereby increase screening efforts to improve diagnosis rates and clinical outcomes for underserved patients in this region.
Background: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe first-line tenofovir use and treatment outcomes in coinfected patients in Asia.
Methods: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started first-line antiretroviral therapy were included.
Introduction. Benzodiazepines (BZDs) and zolpidem, zopiclone, and zaleplon (Z-drugs) are commonly prescribed to HIV-infected patients. We hypothesized that frequent BZD and Z-drug use among these patients may be associated with psychiatric illnesses, particularly in long-term users.
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- CRF 07_BC is the dominant HIV-1 strain in Taiwan among injection drug users and features a significant 7 amino-acid deletion in its p6gag, impacting its viral load and replication.
- In a study comparing patients infected with CRF07_BC and subtype B, those with CRF07_BC demonstrated lower viral loads (about 58,000 copies/ml less) and reduced replicative capacity despite both strains being CCR5-tropic and non-syncytium inducing.
- The deletion in p6gag adversely affects the viral lifecycle, resulting in slower maturation, poorer viral protein production, and less efficient interaction with the Alix protein, contributing to the lower viral loads observed
Article Synopsis
- * Data from 4,662 patients showed a shift from older drugs like stavudine to newer options such as tenofovir, with a notable decrease in treatment failure rates over time.
- * Factors influencing treatment modification due to adverse events included the period of ART initiation, age, sex, hepatitis C status, and the specific ART regimen used.
Article Synopsis
- Despite increased access to antiretroviral therapy (ART) in Asia, many HIV-positive patients still start treatment at advanced stages of the disease, indicated by low CD4 levels.
- A study of 2,737 ART-naïve patients revealed that the median CD4 count at ART initiation rose from 115 cells/mm³ in 2008 to 302 cells/mm³ after 2011, and late ART initiation dropped from 79.1% to 36.3% during the same period.
- Factors influencing late ART initiation included the year of treatment start, male sex, and certain risk behaviors, while those who began treatment late faced higher mortality rates after starting ART.
Objective: To evaluate the T-SPOT.TB interferon-γ releasing assay and the tuberculin skin test (TST), for the diagnosis of latent tuberculosis infection(LTBI) and the development of subsequent active tuberculosis, in BCG-vaccinated HIV-infected individuals.
Methods: HIV-infected individuals without clinical suspicion of active TB or a past history of TB were enrolled from 1 January 2008 to 30 November 2010.
Objectives: Successful clones of Neisseria gonorrhoeae multiantigen sequence typing sequence type (ST) 1407 and ST1407-related genotypes have been reported to cause cefixime and ceftriaxone treatment failure in many countries. We characterized the 47 isolates of a strain cluster of ST4378, a genotype that differs in the porB sequence by only one nucleotide from ST1407, in Taiwan during April 2006 to June 2012.
Methods: We identified 47 ST4378 isolates among our 2357 total isolates from the Gonococci-National Isolate Collection for Epidemiology.
Background: In 2004, HIV-1 infection among Taiwanese injection drug users (IDUs) started to surge. In 2007, a resurgence of HIV-1 epidemic among men having sex with men (MSM) occurred. We conducted a molecular epidemiological study of HIV-1 among different risk groups in Taiwan from 2005 to 2008.
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- - The study aimed to improve the multiplex real-time polymerase chain reaction (RT-PCR) method to identify hepatitis C virus (HCV) subtypes among Taiwanese injection drug users (IDUs), in light of new subtypes of genotype 6 discovered recently.
- - Researchers examined 76 serum samples from 2008, finding that the majority (60.5%) had single HCV infections while 3.9% had double infections, with some cases previously misclassified by existing testing methods.
- - The modified RT-PCR technique proved effective for identifying various HCV subtypes, supporting its use in future molecular epidemiological studies and enhancing lab diagnoses.
Article Synopsis
- HIV-1 infections among men who have sex with men (MSM) in Taiwan were studied in gay saunas from 2001 to 2005, revealing a notable prevalence rate that rose from 3.4% to 8.9% over the years.
- Among the 1,093 MSM surveyed, 7.4% were found to be HIV-1 positive, with all identified strains being subtype B.
- Key risk factors for HIV-1 infection included being uncircumcised, having multiple sexual partners during sauna visits, and taking a versatile role in anal intercourse.