Consequences of low-level viremia among women with HIV in the United States from 2003 - 2020.
AIDS
; 2024 Aug 07.
Article
em En
| MEDLINE
| ID: mdl-39110550
ABSTRACT
OBJECTIVE:
Investigate the outcomes of women with HIV (WWH) with low-level viremia (LLV).DESIGN:
The prevalence of LLV and potential clinical sequelae, such as virologic failure and non-AIDS comorbidity (NACM) development, are poorly characterized among WWH.METHODS:
We analyzed data from the Women's Interagency HIV Study among WWH enrolled from 2003 to 2020 who reported antiretroviral therapy use at least 1âyear followed by an HIV-1 viral load less than 200âcopies/ml. Consecutive viral load measurements from four semi-annual visits were used to categorize women at baseline as having virologic suppression (all viral load undetectable), intermittent LLV (iLLV; nonconsecutive detectable viral load up to 199âcopies/ml), persistent LLV (pLLV; at least two consecutive detectable viral load up to 199âcopies/ml), or virologic failure (any viral load ≥200âcopies/ml). Adjusted hazard ratios quantified the association of virologic category with time to incident virologic failure and multimorbidity (≥2 of 5 NACM) over 5-year follow-up.RESULTS:
Of 1598 WWH, baseline median age was 47âyears, 64% were Black, 21% Hispanic, and median CD4+ cell count was 621âcells/µl. After excluding 275 women (17%) who had virologic failure at baseline, 58, 19, and 6% were categorized as having virologic suppression, iLLV, and pLLV, respectively. Compared with WWH with virologic suppression, the adjusted hazard ratio [aHR; 95% confidence interval (CI)] for incident virologic failure was 1.88 (1.44-2.46) and 2.51 (1.66-3.79) for iLLV and pLLV, respectively; and the aHR for incident multimorbidity was 0.81 (0.54-1.21) and 1.54 (0.88-2.71) for iLLV and pLLV, respectively.CONCLUSION:
Women with iLLV and pLLV had an increased risk of virologic failure. Women with pLLV had a trend towards increased multimorbidity risk.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
AIDS
Assunto da revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Ano de publicação:
2024
Tipo de documento:
Article