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Viral blips during suppressive antiretroviral treatment are associated with high baseline HIV-1 RNA levels

Sörstedt, Erik; Nilsson, Staffan; Blaxhult, Anders; Gisslén, Magnus; Flamholc, Leo LU ; Sönnerborg, Anders and Yilmaz, Aylin (2016) In BMC Infectious Diseases 16(1).
Abstract

Background: Many HIV-1-infected patients on suppressive antiretroviral therapy (ART) have transiently elevated HIV RNA levels. The clinical significance of these viral blips is uncertain. We have determined the incidence of blips and investigated important associations in the Swedish HIV-cohort. Methods: HIV-1-infected ART naïve adults who commenced ART 2007-2013 were retrospectively included. Viral blips were defined as a transient viral load between 50 and 500 copies/mL Subjects not suppressed after six months on ART were excluded. Results: Viral blips were found in 76/735 included subjects (10.3%) and in 90/4449 samples (2.0%). Median blip viral load was 76 copies/mL (range 56-138). Median follow-up time was 170weeks (range 97-240).... (More)

Background: Many HIV-1-infected patients on suppressive antiretroviral therapy (ART) have transiently elevated HIV RNA levels. The clinical significance of these viral blips is uncertain. We have determined the incidence of blips and investigated important associations in the Swedish HIV-cohort. Methods: HIV-1-infected ART naïve adults who commenced ART 2007-2013 were retrospectively included. Viral blips were defined as a transient viral load between 50 and 500 copies/mL Subjects not suppressed after six months on ART were excluded. Results: Viral blips were found in 76/735 included subjects (10.3%) and in 90/4449 samples (2.0%). Median blip viral load was 76 copies/mL (range 56-138). Median follow-up time was 170weeks (range 97-240). Baseline viral load was higher in subjects with viral blips (median log10 4.85 copies/mL) compared with subjects without blips (median log10 4.55 copies/mL) (p < 0.01). There was a significant association between viral blips and risk for subsequent virological failure (p < 0.001). Conclusions: The Swedish national HIV-cohort has a low incidence of viral blips (10%). Blips were associated with high baseline viral load and an increased risk of subsequent virological failure.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antiretroviral therapy, HIV-1, Transient viremia, Viral blip
in
BMC Infectious Diseases
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • scopus:84975295491
ISSN
1471-2334
DOI
10.1186/s12879-016-1628-6
language
English
LU publication?
no
id
577f193a-74ce-4105-89f3-6f9ab9304735
date added to LUP
2017-01-24 08:00:04
date last changed
2017-04-09 04:54:00
@article{577f193a-74ce-4105-89f3-6f9ab9304735,
  abstract     = {<p>Background: Many HIV-1-infected patients on suppressive antiretroviral therapy (ART) have transiently elevated HIV RNA levels. The clinical significance of these viral blips is uncertain. We have determined the incidence of blips and investigated important associations in the Swedish HIV-cohort. Methods: HIV-1-infected ART naïve adults who commenced ART 2007-2013 were retrospectively included. Viral blips were defined as a transient viral load between 50 and 500 copies/mL Subjects not suppressed after six months on ART were excluded. Results: Viral blips were found in 76/735 included subjects (10.3%) and in 90/4449 samples (2.0%). Median blip viral load was 76 copies/mL (range 56-138). Median follow-up time was 170weeks (range 97-240). Baseline viral load was higher in subjects with viral blips (median log<sub>10</sub> 4.85 copies/mL) compared with subjects without blips (median log<sub>10</sub> 4.55 copies/mL) (p &lt; 0.01). There was a significant association between viral blips and risk for subsequent virological failure (p &lt; 0.001). Conclusions: The Swedish national HIV-cohort has a low incidence of viral blips (10%). Blips were associated with high baseline viral load and an increased risk of subsequent virological failure.</p>},
  articleno    = {305},
  author       = {Sörstedt, Erik and Nilsson, Staffan and Blaxhult, Anders and Gisslén, Magnus and Flamholc, Leo and Sönnerborg, Anders and Yilmaz, Aylin},
  issn         = {1471-2334},
  keyword      = {Antiretroviral therapy,HIV-1,Transient viremia,Viral blip},
  language     = {eng},
  month        = {06},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Infectious Diseases},
  title        = {Viral blips during suppressive antiretroviral treatment are associated with high baseline HIV-1 RNA levels},
  url          = {http://dx.doi.org/10.1186/s12879-016-1628-6},
  volume       = {16},
  year         = {2016},
}