Longitudinal viral load outcomes of adults with HIV after detectable viremia on tenofovir, lamivudine, and dolutegravir.
AIDS
; 38(11): 1714-1719, 2024 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-38870005
ABSTRACT
BACKGROUND:
To inform optimal management of HIV viremia on tenofovir, lamivudine, and dolutegravir (TLD), we examined viral load (VL) outcomes of a large cohort of adult PWH on TLD in Nigeria.METHODS:
We conducted a retrospective study of adult PWH who had ≥1 VL after initiating TLD during January 2017-February 2023. VLs were categorized as undetectable (≤50âcopies/ml), low low-level viremia (LLV, 51-199âcopies/ml), high LLV (200-999âcopies/ml), virologic nonsuppression (VLNS, ≥1000âcopies/ml), and virologic failure (VF, ≥2 consecutive VLNS results). Among patients with ≥2 VLs on TLD, we described how viremia changed over time and examined virologic outcomes after VF. We identified predictors of subsequent VLNS using mixed-effects logistic regression and conducted planned contrasts between levels of VL result and regimen types.RESULTS:
Analysis of 82,984 VL pairs from 47,531 patients demonstrated viral resuppression to ≤50âcopies/ml at follow-up VL in 66.7% of those with initial low LLV, 59.1% of those with initial high LLV, and 48.9% of those with initial VLNS. Of 662 patients with a follow-up VL after VF, 94.6% stayed on TLD; of which 57.8% (359/621) were undetectable at next VL without regimen change. Previous low LLV [adjusted odds ratio (aOR) 1.74, 1.56-1.93], high LLV (aOR 2.35, 2.08-2.65), and VLNS (aOR 6.45, 5.81-7.16) were associated with increasingly higher odds of subsequent VLNS, whereas a previously undetectable VL (aOR 1.08, 0.99-1.71) on TLD was not.CONCLUSIONS:
Despite increased odds of subsequent VLNS, most PWH with detectable viremia on TLD, including those with VF, will resuppress to an undetectable VL without a regimen change.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oxazinas
/
Piperazinas
/
Piridonas
/
Viremia
/
Infecções por HIV
/
Lamivudina
/
Fármacos Anti-HIV
/
Carga Viral
/
Tenofovir
/
Compostos Heterocíclicos com 3 Anéis
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article