Prevalence and clinical correlates of HIV viremia ('blips') in patients with previous suppression below the limits of quantification
| Autor: | Douglas J. Ward, Zarina Gafoor, Rose K. Baker, Carlos F. Alzola, Kathleen C. Wood, Hiv Outpatient Study (Hops) Investigators, S D Holmberg, Anne C. Moorman, Peter Sklar |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Anti-HIV Agents Immunology HIV Infections Viremia Gastroenterology Cohort Studies Internal medicine Prevalence medicine Humans Immunology and Allergy Sida biology virus diseases Viral Load biology.organism_classification medicine.disease CD4 Lymphocyte Count Regimen Infectious Diseases Lentivirus Cohort HIV-1 RNA Viral Reverse Transcriptase Inhibitors Drug Therapy Combination Viral disease Viral load Cohort study |
| Zdroj: | AIDS. 16:2035-2041 |
| ISSN: | 0269-9370 |
| Popis: | To examine the prevalence and clinical correlates of subsequently measurable viremia in HIV-infected patients who have achieved viral suppression below the limits of quantification (50 copies/ml).Non-randomized dynamic cohort study of ambulatory HIV patients in nine HIV clinics in eight cities.Patients had two consecutive HIV-1 RNA levels50 copies/ml (minimum, 2 months apart) that were followed by at least two more viral level determinations while remaining on the same antiretroviral therapy (ART) between January 1997 and June 2000 (median 485 days). Transiently viremic patients were defined having a subsequently measurable viremia but again achieved suppression50 copies/ml.Of the 448 patients, 122 (27.2%) had transient viremia, 19 (4.2%) had lasting low-level viremia and 33 (7.4%) had lasting high-level viremia (defined as 50-400 and400 copies/ml, respectively). Only 16 (13.1%) of those who had transient viremia later had persistent viremia50 copies/ml. The occurrence of transient viremia did not vary with whether the patient was ART-naive or experienced (P = 0.31), or currently taking protease inhibitors or not (P = 0.08). On consistent ART, the median percentage increase in CD4 cell count was statistically different between subgroups of our cohort (Kruskal-Wallis, P = 0.002).Transiently detectable viremia, usually 50-400 copies/ml, was frequent among patients who had two consecutive HIV-1 RNA levels below the limits of quantification. In this analysis, such viremia did not appear to affect the risk of developing lasting viremia. Caution is warranted before considering a regimen as 'failing' and changing medications. |
| Databáze: | OpenAIRE |
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