Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy
Objective: To assess the prognostic significance of persistent low-level viraemia (PLV, defined as persistent plasma viral loads of 51-1000 HIV-1 RNA copies/mL for at least 3 months) in patients who had achieved viral suppression on antiretroviral therapy (ART). Methods: A retrospective cohort of HI...
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th-mahidol.235882018-08-20T14:11:02Z Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy Somnuek Sungkanuparph R. K. Groger E. T. Overton V. J. Fraser W. G. Powderly Washington University School of Medicine in St. Louis Mahidol University Mater Misericordiae University Hospital Medicine Objective: To assess the prognostic significance of persistent low-level viraemia (PLV, defined as persistent plasma viral loads of 51-1000 HIV-1 RNA copies/mL for at least 3 months) in patients who had achieved viral suppression on antiretroviral therapy (ART). Methods: A retrospective cohort of HIV-infected patients who received ART, were followed-up for ≥12 months, made regular visits to the clinic during which blood tests were performed for an ultrasensitive HIV RNA assay every 3 months, and achieved viral loads <50copies/mL were evaluated. Virological failure was defined as two consecutive viral load measurements >1000copies/mL. Results: Of 362 patients, 78 (27.5%) experienced PLV. The demographics of patients with and without PLV were similar. PLV occurred at a mean (±standard deviation) of 22.6±16.9 months after ART initiation and lasted for 6.4±3.4 months. During a median follow-up of 29.5 months, patients with PLV had a higher rate of virological failure (39.7%; vs 9.2%; P <0.001). The median time to failure was 68.4 months [95% confidence interval (CI) 37.0-99.7] for patients with PLV and >72 months for patients without PLV (log rank test, P <0.001). By Cox regression, patients with PLV had a greater risk of virological failure [hazard ratio (HR) 3.8; 95% CI 2.2-6.4; P <0.001]. Among patients with PLV, a PLV of >400copies/mL (HR 3.3; 95% CI 1.5-7.1; P =0.003) and a history of ART (HR 2.4; 95% CI 1.0-5.7; P =0.042) predicted virological failure. Conclusions: PLV is associated with virological failure. Patients with a PLV >400copies/mL and a history of ART experience are more likely to experience virological failure. Patients with PLV should be considered for treatment optimization and interventional studies. © 2006 British HIV Association. 2018-08-20T07:11:02Z 2018-08-20T07:11:02Z 2006-10-01 Article HIV Medicine. Vol.7, No.7 (2006), 437-441 10.1111/j.1468-1293.2006.00403.x 14681293 14642662 2-s2.0-33747689078 https://repository.li.mahidol.ac.th/handle/123456789/23588 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=33747689078&origin=inward |
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Medicine Somnuek Sungkanuparph R. K. Groger E. T. Overton V. J. Fraser W. G. Powderly Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
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Objective: To assess the prognostic significance of persistent low-level viraemia (PLV, defined as persistent plasma viral loads of 51-1000 HIV-1 RNA copies/mL for at least 3 months) in patients who had achieved viral suppression on antiretroviral therapy (ART). Methods: A retrospective cohort of HIV-infected patients who received ART, were followed-up for ≥12 months, made regular visits to the clinic during which blood tests were performed for an ultrasensitive HIV RNA assay every 3 months, and achieved viral loads <50copies/mL were evaluated. Virological failure was defined as two consecutive viral load measurements >1000copies/mL. Results: Of 362 patients, 78 (27.5%) experienced PLV. The demographics of patients with and without PLV were similar. PLV occurred at a mean (±standard deviation) of 22.6±16.9 months after ART initiation and lasted for 6.4±3.4 months. During a median follow-up of 29.5 months, patients with PLV had a higher rate of virological failure (39.7%; vs 9.2%; P <0.001). The median time to failure was 68.4 months [95% confidence interval (CI) 37.0-99.7] for patients with PLV and >72 months for patients without PLV (log rank test, P <0.001). By Cox regression, patients with PLV had a greater risk of virological failure [hazard ratio (HR) 3.8; 95% CI 2.2-6.4; P <0.001]. Among patients with PLV, a PLV of >400copies/mL (HR 3.3; 95% CI 1.5-7.1; P =0.003) and a history of ART (HR 2.4; 95% CI 1.0-5.7; P =0.042) predicted virological failure. Conclusions: PLV is associated with virological failure. Patients with a PLV >400copies/mL and a history of ART experience are more likely to experience virological failure. Patients with PLV should be considered for treatment optimization and interventional studies. © 2006 British HIV Association. |
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Washington University School of Medicine in St. Louis |
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Washington University School of Medicine in St. Louis Somnuek Sungkanuparph R. K. Groger E. T. Overton V. J. Fraser W. G. Powderly |
format |
Article |
author |
Somnuek Sungkanuparph R. K. Groger E. T. Overton V. J. Fraser W. G. Powderly |
author_sort |
Somnuek Sungkanuparph |
title |
Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
title_short |
Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
title_full |
Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
title_fullStr |
Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
title_full_unstemmed |
Persistent low-level viraemia and virological failure in HIV-1-infected patients treated with highly active antiretroviral therapy |
title_sort |
persistent low-level viraemia and virological failure in hiv-1-infected patients treated with highly active antiretroviral therapy |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/23588 |
_version_ |
1763494998046670848 |