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Low-level HIV viraemia during antiretroviral therapy: Longitudinal patterns and predictors of viral suppression.
Elén, S; Björkman, P; Zazzi, M; Böhm, M; Bernal, E; Sönnerborg, A; Elvstam, O.
Afiliación
  • Elén S; Department of Translational Medicine, Lund University, Malmö, Sweden.
  • Björkman P; Department of Translational Medicine, Lund University, Malmö, Sweden.
  • Zazzi M; Department of Infectious Diseases, Skåne University Hospital, Malmö, Sweden.
  • Böhm M; Department of Medical Biotechnology, University of Siena, Siena, Italy.
  • Bernal E; Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
  • Sönnerborg A; Infectious Disease Unit. Reina Sofia Hospital, Murcia University and IMIB, Murcia, Spain.
  • Elvstam O; Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden.
HIV Med ; 25(1): 107-116, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37721192
OBJECTIVES: Our objective was to characterize longitudinal patterns of viraemia and factors associated with viral suppression in people with HIV and low-level viraemia (LLV) during antiretroviral therapy (ART). METHODS: We included people with HIV in the EuResist Integrated Database with LLV following ART initiation after 2005. LLV was defined as two or more consecutive viral load (VL) measurements of 51-199 copies/mL 30-365 days apart after >12 months of ART. Viraemia patterns were analyzed over 24 months. Factors associated with viral suppression at 12 months after LLV episodes were identified using univariable and multivariable logistic regression. RESULTS: Of 25 113 people with HIV, 2474 (9.9%) had LLV. Among 1387 participants with 24 months of follow-up after LLV, 406 (29%) had persistent suppression, 669 (48%) had transient viraemic episodes, 29 (2%) had persistent LLV, and 283 (20%) had virological failure. Following LLV episodes, the proportion with detectable viraemia declined (p for trend <0.001 and 0.034, in the first and second year, respectively). At 12 months, 68% had undetectable VL, which was associated with suppression before LLV (adjusted odds ratio [aOR] 1.7; 95% confidence interval [CI] 1.2-2.4) and ART modification after LLV (aOR 1.6; 95% CI 1.0-2.4). The following factors were negatively associated with undetectable VL at 12 months: higher VL during LLV (aOR 0.57 per log10 copies/mL; 95% CI 0.37-0.89), injecting drug use (aOR 0.67; 95% CI 0.47-0.96), and regimens with protease inhibitors (aOR 0.65; 95% CI 0.49-0.87) or combined anchor drugs (aOR 0.52; 95% CI 0.32-0.85). CONCLUSION: Most people with LLV did not experience sustained viral suppression during 24-month follow-up, supporting the association between LLV and inferior treatment outcome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: HIV Med Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: HIV Med Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido