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Dear Editor: In Asia, an estimated 4.8 million people were living with HIV in 2012. Women accounted for a growing proportion of HIV infections, increasing from 21% in 1990 to 35% in 2009. Gender-based analysis in clinical and operational research is still considered understudied. Better understanding of the differences in clinical management, care delivery, and outcomes between males and females in this region may enhance individualization of treatment and improve efficacy and safety outcomes of highly active antiretroviral therapy (HAART). The study objective was to evaluate the effect of sex on viro-immunological responses to HAART, treatment outcomes, and toxicities in a regional observational cohort in the Asia-Pacific. Established in 2003, the TREAT Asia HIV Observational Database (TAHOD) is a collaborative observational cohort study involving 21 sites in 12 countries in the Asia-Pacific region. Detailed methods have previously been published. Briefly, observational data on a range of demographic variables, clinical outcomes, and laboratory testing results are semi-annually transferred to a common data management center. Ethical approvals are obtained from participating sites, the coordinating center, and the data management and biostatistics center. Endpoints for this analysis included changes in CD4 count, proportions of patients with undetectable HIV viral load at 96 weeks after HAART initiation, rates of new AIDS or death, loss to follow-up (defined as not seen in clinic for > 12 months), treatment change due to toxicity, and frequency of CD4 and HIV viral load monitoring. Stepwise multivariate linear regression and logistic regression models were used to evaluate the independent associations of baseline variables with change in CD4 counts and proportion of patients reaching undetectable HIV viral load ( < 500 copies/mL) at 96 weeks. Multivariate Cox proportional hazards models were used to determine predictors of new AIDS or death, loss

Impact of Gender on Long-Term Treatment Outcomes of Highly Active Antiretroviral Therapy (HAART) in the TREAT Asia HIV Observational Database