Title |
Transient detectable viremia and the risk of viral rebound in patients from the Swiss HIV Cohort Study
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Published in |
BMC Infectious Diseases, September 2015
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DOI | 10.1186/s12879-015-1120-8 |
Pubmed ID | |
Authors |
Jim Young, Martin Rickenbach, Alexandra Calmy, Enos Bernasconi, Cornelia Staehelin, Patrick Schmid, Matthias Cavassini, Manuel Battegay, Huldrych F. Günthard, Heiner C. Bucher, the Swiss HIV Cohort Study |
Abstract |
Temporary increases in plasma HIV RNA ('blips') are common in HIV patients on combination antiretroviral therapy (cART). Blips above 500 copies/mL have been associated with subsequent viral rebound. It is not clear if this relationship still holds when measurements are made using newer more sensitive assays. We selected antiretroviral-naive patients that then recorded one or more episodes of viral suppression on cART with HIV RNA measurements made using more sensitive assays (lower limit of detection below 50 copies/ml). We estimated the association in these episodes between blip magnitude and the time to viral rebound. Four thousand ninety-four patients recorded a first episode of viral suppression on cART using more sensitive assays; 1672 patients recorded at least one subsequent suppression episode. Most suppression episodes (87 %) were recorded with TaqMan version 1 or 2 assays. Of the 2035 blips recorded, 84 %, 12 % and 4 % were of low (50-199 copies/mL), medium (200-499 copies/mL) and high (500-999 copies/mL) magnitude respectively. The risk of viral rebound increased as blip magnitude increased with hazard ratios of 1.20 (95 % CI 0.89-1.61), 1.42 (95 % CI 0.96-2.19) and 1.93 (95 % CI 1.24-3.01) for low, medium and high magnitude blips respectively; an increase of hazard ratio 1.09 (95 % CI 1.03 to 1.15) per 100 copies/mL of HIV RNA. With the more sensitive assays now commonly used for monitoring patients, blips above 200 copies/mL are increasingly likely to lead to viral rebound and should prompt a discussion about adherence. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Egypt | 1 | 13% |
United States | 1 | 13% |
Unknown | 6 | 75% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 6 | 75% |
Practitioners (doctors, other healthcare professionals) | 2 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 53 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 13 | 25% |
Student > Ph. D. Student | 8 | 15% |
Researcher | 7 | 13% |
Other | 4 | 8% |
Student > Bachelor | 3 | 6% |
Other | 8 | 15% |
Unknown | 10 | 19% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 18 | 34% |
Nursing and Health Professions | 5 | 9% |
Agricultural and Biological Sciences | 4 | 8% |
Biochemistry, Genetics and Molecular Biology | 3 | 6% |
Immunology and Microbiology | 3 | 6% |
Other | 8 | 15% |
Unknown | 12 | 23% |