Time spent with HIV-RNA ≤ 200 copies/ml in a cohort of people with HIV during the U=U era
| Autor: | Carlo Federico Perno, Franco Maggiolo, Giordano Madeddu, Enrico Girardi, Alessandro Cozzi-Lepri, Roberta Gagliardini, Antonella Cingolani, Andrea Antinori, Antonella d'Arminio Monforte, Giulia Marchetti, Andrea De Vito, Annalisa Saracino |
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| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Anti-HIV Agents Immunology Human immunodeficiency virus (HIV) HIV Infections Logistic regression medicine.disease_cause Time Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Immunology and Allergy 030212 general & internal medicine business.industry Viral Load 030104 developmental biology Infectious Diseases Serodiscordant Cohort RNA Population study Female Observational study business Viral load Demography Cohort study |
| Zdroj: | AIDS. 35:1103-1112 |
| ISSN: | 1473-5571 0269-9370 |
| Popis: | Objective Zero risk of linked HIV transmission in serodiscordant couples when the HIV-infected partner had viral load less than 200 copies/ml ('U status') was found in observational studies. We aimed at estimating the proportion of time in which 'U status' was maintained and identifying factors associated with the risk of losing it. Design Observational cohort study. Methods We included participants in the ICONA cohort who had reached an established 'U status' (viral load ≤200 copies/ml for >6 months) as of December 2010. The outcome was the number of person-days of follow-up (PDFU) above a viral load greater than 200 copies/ml, relative to the total number of PDFU observed. A logistic regression model was used to identify factors independently associated with the risk of losing 'U status'. Results Eight thousand, two hundred and forty-one persons living with HIV were included in the analysis who contributed 2 670 888 PDFU. Of these, 1648 (20%) were women, 768 (9%) were people who inject drugs (PWID), and 2066 (25%) were foreign-born. The median of viral load measurements was 9 (IQR: 4-15). Overall, only 3.1% of PDFU were observed when viral load was above 200 copies/ml. The proportion of PDFU with viral load more than 200 copies/ml was higher than average in women (5.3%), unemployed (5.4%), PWID (4.7%), and in people with more than three previous virologic failures (6.3%). These variables were significant predictors of losing 'U status' in the multivariable logistic regression. Conclusion Our results reinforce the validity of the U=U message in real-world setting. However, we identified subsets of our study population at higher risk of losing the 'U status' for whom additional efforts are needed. |
| Databáze: | OpenAIRE |
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