A Single Quantifiable Viral Load Is Predictive of Virological Failure in Human Immunodeficiency Virus (HIV)-Infected Patients on Combination Antiretroviral Therapy: The Austrian HIV Cohort Study. (15th June 2016)

• Record Type: Journal Article
• Authors: Leierer, Gisela; Grabmeier-Pfistershammer, Katharina; Steuer, Andrea; Sarcletti, Mario; Geit, Maria; Haas, Bernhard; Taylor, Ninon; Kanatschnig, Manfred; Rappold, Michaela; Ledergerber, Bruno; Zangerle, Robert; Egle, Alexander; Geit, Maria; Haas, Bernhard; Kanatschnig, Manfred; Rieger, Armin; Steuer, Andrea; Zangerle, Robert; Gisinger, Martin; Kitchen, Maria; Rieser, Elisabeth; Rühr, Brigitte; Sarcletti, Mario; Zangerle, Robert; Greil, Richard; Schachner, Michaela; Taylor, Ninon; Berg, Jörg; Öllinger, Angela; Aichwalder, Regina; Grabmeier-Pfistershammer, Katharina; Touzeau, Veronique; Cichon, Piotr; Gartner, Manfred; Schmied, Brigitte; Steuer, Andrea; Haas, Bernhard; Kapper, Andreas; Wallner, Elmar; Puchhammer-Stöckl, Elisabeth; Appoyer, Heinz; Leierer, Gisela; Rappold, Michaela; Strickner, Stefanie; Schindelwig, Klaus; Ledergerber, Bruno; Fätkenheuer, Gerd;
• Is Part Of: Open forum infectious diseases. Volume 3:Number 2(2016)
• Publication Date: 2016-06-15
• Subjects: cART -- HIV -- low-level viremia -- viral load -- virological failure; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofw089
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background. Viral loads (VLs) detectable at low levels are not uncommon in patients on combination antiretroviral therapy (cART). We investigated whether a single quantifiable VL predicted virological failure (VF). Methods. We analyzed patients receiving standard regimens with at least 1 VL measurement below the limit of quantification (BLQ) in their treatment history. The first VL measurement after 6 months of unmodified cART served as baseline VL for the subsequent analyses of the time to reach single VL levels of ≥200, ≥400, and ≥1000 copies/mL. Roche TaqMan 2.0 was used to quantify human immunodeficiency virus-1 ribonucleic acid. Factors associated with VF were determined by Cox proportional hazards models. Results. Of 1614 patients included in the study, 68, 44, and 34 experienced VF ≥200, ≥400, and ≥1000 copies/mL, respectively. In multivariable analyses, compared with patients who were BLQ, a detectable VL ≤ 50 and VL 51–199 copies/mL predicted VF ≥ 200 copies/mL (hazards ratio [HR] = 2.19, 95% confidence interval [CI] = 1.06–4.55 and HR = 4.21, 95% CI = 2.15–8.22, respectively). In those with VL 51–199 copies/mL, a trend for an increased risk of VF ≥400 and VF ≥1000 copies/mL could be found (HR = 2.13, 95% CI = 0.84–5.39 and HR = 2.52, 95% CI = 0.96–6.60, respectively). Conclusions. These findings support closer monitoring and adherence counseling for patients with a single measurement of quantifiable VL <200 copies/mL.