Impact of pre-antiretroviral treatment HIV-RNA on time to successful virological suppression and subsequent virological failure - two nationwide, population-based cohort studies
(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
- Sörstedt, Erik ; Tetens, Malte Mose ; Nilsson, Staffan ; Nowak, Piotr ; Treutiger, Carl Johan ; Månsson, Fredrik LU ; Änghagen, Lena ; Gisslén, Magnus ; Obel, Niels and Yilmaz, Aylin
- organization
- publishing date
- 2023-02-01
- 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
-
- pmid:36541640
- scopus:85144253558
- 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
- 2024-12-27 07:49:01
@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 < 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.</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}}, }