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Evaluating HIV Viral Rebound Among Persons on Suppressive Antiretroviral Treatment in the Era of "Undetectable Equals Untransmittable (U = U)".
Min, Sugi; Gillani, Fizza S; Aung, Su; Garland, Joseph M; Beckwith, Curt G.
Afiliação
  • Min S; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
  • Gillani FS; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
  • Aung S; The Miriam Hospital, Providence, Rhode Island, USA.
  • Garland JM; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
  • Beckwith CG; The Miriam Hospital, Providence, Rhode Island, USA.
Open Forum Infect Dis ; 7(12): ofaa529, 2020 Dec.
Article em En | MEDLINE | ID: mdl-33335935
ABSTRACT

BACKGROUND:

Studies have demonstrated that persons with HIV (PWH) maintaining viral suppression do not transmit HIV to HIV-negative partners through condomless sex, leading to the "Undetectable = Untransmittable (U = U)" prevention campaign. However, few studies have examined the durability of suppression in the era of U = U.

METHODS:

This retrospective cohort study was conducted in Providence, Rhode Island. PWH aged ≥18 years with documented viral suppression (defined as at least 1 viral load [VL] <200 copies/mL and no VL ≥200 copies/mL) in 2015 were included in the baseline cohort. Primary outcomes were viral suppression, viral rebound (at least 1 VL ≥200 copies/mL), or gap in VL monitoring assessed annually from 2016 to 2019. Those with viral rebound were assessed for resuppression within 6 months. Demographic and clinical characteristics associated with viral rebound or gaps in VL monitoring were investigated by bivariate analysis and logistic regression.

RESULTS:

A total of 1242 patients with viral suppression were included in the baseline cohort. In each follow-up year, 85%-90% maintained viral suppression, 2%-5% experienced viral rebound, and 8%-10% had a gap in VL monitoring. Among those with viral rebound, approximately one-half were suppressed again within 6 months. In the logistic regression models, retention in care was significantly associated with viral suppression, while younger age, black race, high school or equivalent education, non-men who have sex with men, and history of incarceration were significantly associated with viral rebound.

CONCLUSIONS:

In the U = U era, most patients with viral suppression who are retained in care are likely to maintain viral suppression over time. Some patients require additional support for regular VL monitoring.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos