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.

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.

SUBMITTER: Leierer G 

PROVIDER: S-EPMC4943568 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature