Consequences of low-level viremia among women with HIV in the United States.

Autor:	Aldredge A; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.; Grady Healthcare System, Ponce de Leon Center., Mehta CC; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA., Lahiri CD; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.; Grady Healthcare System, Ponce de Leon Center., Schneider MF; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD., Alcaide ML; Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, FL., Anastos K; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY., Plankey M; Division of General Internal Medicine, Department of Medicine, Georgetown University, DC., French AL; Division of Infectious Diseases, Department of Medicine, Stroger Hospital of Cook County, Chicago, IL., Floris-Moore M; Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC., Tien PC; Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA., Dionne J; Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL., Dehovitz J; Division of Infectious Diseases, SUNY Downstate Health Sciences University, Brooklyn, NY, USA., Collins LF; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.; Grady Healthcare System, Ponce de Leon Center., Sheth AN; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.; Grady Healthcare System, Ponce de Leon Center.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2024 Nov 01; Vol. 38 (13), pp. 1829-1838. Date of Electronic Publication: 2024 Aug 28.
DOI:	10.1097/QAD.0000000000003990
Abstrakt:	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 1 year followed by an HIV-1 viral load less than 200 copies/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 199 copies/ml), persistent LLV (pLLV; at least two consecutive detectable viral load up to 199 copies/ml), or virologic failure (any viral load ≥200 copies/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 47 years, 64% were Black, 21% Hispanic, and median CD4 + cell count was 621 cells/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. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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