Time above 1500 copies. (15th May 2015)

• Record Type: Journal Article
• Authors: Marks, Gary; Gardner, Lytt I.; Rose, Charles E.; Zinski, Anne; Moore, Richard D.; Holman, Susan; Rodriguez, Allan E.; Sullivan, Meg; Giordano, Thomas P.
• Is Part Of: AIDS. Volume 29:Number 8(2015)
• Publication Date: 2015-05-15
• Subjects: AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000000640
• Languages: English
• ISSNs: 0269-9370

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>We examined HIV transmission potential of patients in care by analyzing the amount of person-time spent above a viral load threshold that increases risk for transmission.</p> </sec> <sec> <title>Design:</title> <p>Observational cohort and supplemental data.</p> </sec> <sec> <title>Methods:</title> <p>The cohort included HIV patients who received care at six HIV clinics in the United States, from 1 April 2009 to 31 March 2013, and had two or more viral load tests during this interval. Person-time (in days) above a viral load of 1500 copies/ml out of the total observation time was determined by inspecting consecutive pairs of viral load results and the time intervals between those pairs. The person-time rate ratios comparing demographic and clinical subgroups were estimated with Poisson regression.</p> </sec> <sec> <title>Results:</title> <p>The cohort included 14 532 patients observed for a median of 1073 days with a median of nine viral load records. Ninety percent of the patients had been prescribed antiretroviral therapy. On average, viral load exceeded 1500 copies/ml during 23% of the patients' observation time (average of 84 days per year, per patient). Percentage of person-time above the threshold was higher among patients who had more than a fourth of their viral load pairs exceeding a 6-month interval (34% of observation time), patients not on antiretroviral therapy (58% of time), new/re-engaging patients (34% of time), patients 16–39 years of age (32% of time), and patients of black race (26% of time).</p> </sec> <sec> <title>Conclusion:</title> <p>HIV patients in care spent an average of nearly a quarter of their time with viral loads above 1500 copies/ml, higher among some subgroups, placing them at risk for potentially transmitting HIV to others.</p> </sec> </abstract>