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Impact of pre-antiretroviral treatment HIV-RNA on time to successful virological suppression and subsequent virological failure - two nationwide, population-based cohort studies

Sörstedt, Erik ; Tetens, Malte Mose ; Nilsson, Staffan ; Nowak, Piotr ; Treutiger, Carl Johan ; Månsson, Fredrik LU ; Änghagen, Lena ; Gisslén, Magnus ; Obel, Niels and Yilmaz, Aylin (2023) In AIDS 37(2). p.279-286
Abstract

Background: The impact of pre-antiretroviral treatment (ART) HIV-RNA on time to successful virological suppression and subsequent failure in HIV patients remains poorly investigated. Methods: We used the Swedish InfCareHIV database and the Danish HIV Cohort Study to evaluate impact of pre-ART HIV-RNA on primary virological suppression (HIV-RNA < 50copies/ml) and risk of secondary virological failure (two consecutive HIV-RNA > 200copies/ml or one >1000copies/ml). The study included 3366 Swedish and 2050 Danish ART naïve individuals who initiated ART in the period 2000-2018. We used Kaplan-Meier estimates and Cox regression analyses to estimate absolute risks and hazard ratios. Results: In both cohorts, more than 95% of patients... (More)

Background: The impact of pre-antiretroviral treatment (ART) HIV-RNA on time to successful virological suppression and subsequent failure in HIV patients remains poorly investigated. Methods: We used the Swedish InfCareHIV database and the Danish HIV Cohort Study to evaluate impact of pre-ART HIV-RNA on primary virological suppression (HIV-RNA < 50copies/ml) and risk of secondary virological failure (two consecutive HIV-RNA > 200copies/ml or one >1000copies/ml). The study included 3366 Swedish and 2050 Danish ART naïve individuals who initiated ART in the period 2000-2018. We used Kaplan-Meier estimates and Cox regression analyses to estimate absolute risks and hazard ratios. Results: In both cohorts, more than 95% of patients with a pre-ART HIV-RNA <100 000copies/ml obtained virological suppression within the first year after ART initiation contrasting 74% (Sweden) and 86% (Denmark) in those with HIV-RNA >1 000 000copies/ml. Almost all patients obtained virological suppression after four years irrespective of pre-ART HIV-RNA. In contrast, we observed no substantial impact of pre-ART HIV-RNA on risk of virological failure once virological suppression was obtained. Conclusion: High pre-ART HIV-RNA is strongly associated with increased time to successful virological suppression, but pre-ART HIV-RNA has no impact on risk of subsequent virological failure.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antiretroviral therapy, CD4nadir, HIV-RNA, pre-antiretroviral therapy HIV-RNA
in
AIDS
volume
37
issue
2
pages
8 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85144253558
  • pmid:36541640
ISSN
0269-9370
DOI
10.1097/QAD.0000000000003425
language
English
LU publication?
yes
id
c2919534-8162-4e20-8e90-cd7dc8e960d6
date added to LUP
2023-02-02 12:09:57
date last changed
2024-07-11 13:05:05
@article{c2919534-8162-4e20-8e90-cd7dc8e960d6,
  abstract     = {{<p>Background: The impact of pre-antiretroviral treatment (ART) HIV-RNA on time to successful virological suppression and subsequent failure in HIV patients remains poorly investigated. Methods: We used the Swedish InfCareHIV database and the Danish HIV Cohort Study to evaluate impact of pre-ART HIV-RNA on primary virological suppression (HIV-RNA &lt; 50copies/ml) and risk of secondary virological failure (two consecutive HIV-RNA &gt; 200copies/ml or one &gt;1000copies/ml). The study included 3366 Swedish and 2050 Danish ART naïve individuals who initiated ART in the period 2000-2018. We used Kaplan-Meier estimates and Cox regression analyses to estimate absolute risks and hazard ratios. Results: In both cohorts, more than 95% of patients with a pre-ART HIV-RNA &lt;100 000copies/ml obtained virological suppression within the first year after ART initiation contrasting 74% (Sweden) and 86% (Denmark) in those with HIV-RNA &gt;1 000 000copies/ml. Almost all patients obtained virological suppression after four years irrespective of pre-ART HIV-RNA. In contrast, we observed no substantial impact of pre-ART HIV-RNA on risk of virological failure once virological suppression was obtained. Conclusion: High pre-ART HIV-RNA is strongly associated with increased time to successful virological suppression, but pre-ART HIV-RNA has no impact on risk of subsequent virological failure.</p>}},
  author       = {{Sörstedt, Erik and Tetens, Malte Mose and Nilsson, Staffan and Nowak, Piotr and Treutiger, Carl Johan and Månsson, Fredrik and Änghagen, Lena and Gisslén, Magnus and Obel, Niels and Yilmaz, Aylin}},
  issn         = {{0269-9370}},
  keywords     = {{antiretroviral therapy; CD4nadir; HIV-RNA; pre-antiretroviral therapy HIV-RNA}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{2}},
  pages        = {{279--286}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{AIDS}},
  title        = {{Impact of pre-antiretroviral treatment HIV-RNA on time to successful virological suppression and subsequent virological failure - two nationwide, population-based cohort studies}},
  url          = {{http://dx.doi.org/10.1097/QAD.0000000000003425}},
  doi          = {{10.1097/QAD.0000000000003425}},
  volume       = {{37}},
  year         = {{2023}},
}