Low-level HIV viraemia during antiretroviral therapy : Longitudinal patterns and predictors of viral suppression
(2024) In HIV Medicine 25(1). p.107-116- Abstract
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... (More)
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 log
10 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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- author
- Elén, S ; Björkman, P LU ; Zazzi, M ; Böhm, M ; Bernal, E ; Sönnerborg, A and Elvstam, O LU
- author collaboration
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- in
- HIV Medicine
- volume
- 25
- issue
- 1
- pages
- 107 - 116
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85171385288
- pmid:37721192
- ISSN
- 1468-1293
- DOI
- 10.1111/hiv.13541
- language
- English
- LU publication?
- yes
- additional info
- © 2023 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
- id
- 913a41a0-1899-408d-95df-45db59f6c87a
- date added to LUP
- 2023-09-21 08:40:14
- date last changed
- 2024-09-06 14:46:17
@article{913a41a0-1899-408d-95df-45db59f6c87a, abstract = {{<p>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).</p><p>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.</p><p>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 log<br> 10 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).<br> </p><p>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.</p>}}, author = {{Elén, S and Björkman, P and Zazzi, M and Böhm, M and Bernal, E and Sönnerborg, A and Elvstam, O}}, issn = {{1468-1293}}, language = {{eng}}, number = {{1}}, pages = {{107--116}}, publisher = {{Wiley-Blackwell}}, series = {{HIV Medicine}}, title = {{Low-level HIV viraemia during antiretroviral therapy : Longitudinal patterns and predictors of viral suppression}}, url = {{http://dx.doi.org/10.1111/hiv.13541}}, doi = {{10.1111/hiv.13541}}, volume = {{25}}, year = {{2024}}, }