Long-term durability of HIV viral load suppression

Purpose. To determine immunological and virological failure and associated factors among children infected with human immunodeficiency virus receiving antiretroviral treatments at Hawassa University Hospital, Southern Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 273 HIV-infected children from July 1 to December 1, 2019. Data were collected using a structured questionnaire and review of patient records. Blood samples for viral load and CD4 count were collected. Data were analyzed using SPSS version 20. Significance group comparison was done by the Kaplan-Meier log-rank test. The Cox proportional hazard model was used to select significant factors of the variability between groups. Results. A total of 273 children, between the age ranges of 1 to 14 years, were included. Of these, 139 (50.9%) and 134 (49.1%) were males and females, respectively. Children from the rural area were almost five times more vulnerable for virological and immunological failure than those children from the urban area ( AOR = 4.912 , (1.276-8.815), P = 0.032 ). The overall viral load suppression was 196 (71.8%) with a good adherence of 226 (82.9%). Nonsuppressed HIV viral load was found to be 77 (28.2%) which had two times more viral load copies ( AOR = 2.01 , (1.21–2.66), P = 0.001 ) when compared to those who had suppressed viral load copies. The proportions of children who had immunological nonresponse were 45.6% (21 out of 46), 30.4% (14 out of 46), and 23.9% (11 out of 46) among children with baseline CD4 of <200, 201-500, and >500 cells/μl, respectively. Unimproved outcomes among females were noted for immunological and virological failure in this study ( AOR = 1.901 , (1.038-3.481), P = 0.038 ). Conclusion. In conclusion, the highly active antiretroviral treatment appeared highly effective in terms of immunological and virological long-term outcomes. However, viral suppression (71.8%) in our study was far apart from the UNAIDS target of 90% in 2020. For that reason, strengthening adherence counseling and early initiation of HAART is important.

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Current Status Towards 90-90-90 UNAIDS Target and Factors Associated with HIV Viral Load Suppression in Kediri City, Indonesia

HIV/AIDS - Research and Palliative Care ◽

10.2147/hiv.s231173 ◽

2020 ◽

Vol Volume 12 ◽

pp. 47-57

Author(s):

Geofrey Ssekalembe ◽

Muhammad Atoillah Isfandiari ◽

Hendick Suprianto

Keyword(s):

Viral Load ◽

Current Status ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Factors Associated

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Prevalence of viral load suppression, predictors of virological failure and patterns of HIV drug resistance after 12 and 48 months on first-line antiretroviral therapy: a national cross-sectional survey in Uganda

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkz561 ◽

2020 ◽

Vol 75 (5) ◽

pp. 1280-1289

Author(s):

Deogratius Ssemwanga ◽

Juliet Asio ◽

Christine Watera ◽

Maria Nannyonjo ◽

Faridah Nassolo ◽

...

Keyword(s):

Drug Resistance ◽

Viral Load ◽

Virological Failure ◽

Dried Blood Spots ◽

Viral Load Suppression ◽

First Line ◽

Hiv Viral Load ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Weighted Prevalence

Abstract Objectives We implemented the WHO cross-sectional survey protocol to determine rates of HIV viral load (VL) suppression (VLS), and weighted prevalence, predictors and patterns of acquired drug resistance (ADR) in individuals with virological failure (VF) defined as VL ≥1000 copies/mL. Methods We enrolled 547 and 1064 adult participants on first-line ART for 12 (±3) months (ADR12) and ≥48 months (ADR48), respectively. Dried blood spots and plasma specimens were collected for VL testing and genotyping among the VFs. Results VLS was 95.0% (95% CI 93.4%–96.5%) in the ADR12 group and 87.9% (95% CI 85.0%–90.9%) in the ADR48 group. The weighted prevalence of ADR was 96.1% (95% CI 72.9%–99.6%) in the ADR12 and 90.4% (95% CI 73.6–96.8%) in the ADR48 group, out of the 30 and 95 successful genotypes in the respective groups. Initiation on a zidovudine-based regimen compared with a tenofovir-based regimen was significantly associated with VF in the ADR48 group; adjusted OR (AOR) 1.96 (95% CI 1.13–3.39). Independent predictors of ADR in the ADR48 group were initiation on a zidovudine-based regimen compared with tenofovir-based regimens, AOR 3.16 (95% CI 1.34–7.46) and ART duration of ≥82 months compared with <82 months, AOR 1.92 (95% CI 1.03–3.59). Conclusions While good VLS was observed, the high prevalence of ADR among the VFs before they underwent the recommended three intensive adherence counselling (IAC) sessions followed by repeat VL testing implies that IAC prior to treatment switching may be of limited benefit in improving VLS.

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Daily and near-daily cannabis use is associated with HIV viral load suppression in people living with HIV who use cocaine

AIDS Care ◽

10.1080/09540121.2020.1799922 ◽

2020 ◽

pp. 1-8

Author(s):

Deepika E. Slawek ◽

Julia Arnsten ◽

Nancy Sohler ◽

Chenshu Zhang ◽

Robert Grossberg ◽

...

Keyword(s):

Viral Load ◽

Cannabis Use ◽

People Living With Hiv ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Living With Hiv

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Enhanced HIV viral load suppression with crushed combination tablets containing tenofovir alafenamide and emtricitabine

American Journal of Health-System Pharmacy ◽

10.2146/180090 ◽

2018 ◽

Vol 75 (10) ◽

pp. 594-595 ◽

Cited By ~ 3

Author(s):

Patricia Pecora Fulco ◽

Robert T. Higginson

Keyword(s):

Viral Load ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Tenofovir Alafenamide

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HIV Viral Load Suppression in Adults and Children Receiving Antiretroviral Therapy—Results From the IeDEA Collaboration

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001499 ◽

2017 ◽

Vol 76 (3) ◽

pp. 319-329 ◽

Cited By ~ 21

Author(s):

Awachana Jiamsakul ◽

Azar Kariminia ◽

Keri N. Althoff ◽

Carina Cesar ◽

Claudia P. Cortes ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Therapy ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Adults And Children

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COVID-19 infections post-vaccination by HIV status in the United States

10.1101/2021.12.02.21267182 ◽

2021 ◽

Author(s):

Sally B. Coburn ◽

Elizabeth Humes ◽

Raynell Lang ◽

Cameron Stewart ◽

Brenna C Hogan ◽

...

Keyword(s):

Viral Load ◽

Cumulative Incidence ◽

The United States ◽

Infection Risk ◽

Hiv Status ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Post Vaccination ◽

Increased Risk ◽

Vaccine Type

ABSTRACTImportanceRecommendations for additional doses of COVID vaccine are restricted to people with HIV who have advanced disease or unsuppressed HIV viral load. Understanding SARS-CoV-2 infection risk post-vaccination among PWH is essential for informing vaccination guidelines.ObjectiveEstimate the risk of breakthrough infections among fully vaccinated people with (PWH) and without (PWoH) HIV in the US.Design, setting, and participantsThe Corona-Infectious-Virus Epidemiology Team (CIVET)-II cohort collaboration consists of 4 longitudinal cohorts from integrated health systems and academic health centers. Each cohort identified individuals ≥18 years old, in-care, and fully vaccinated for COVID-19 through 30 June 2021. PWH were matched to PWoH on date fully vaccinated, age group, race/ethnicity, and sex at birth. Incidence rates per 1,000 person-years and cumulative incidence of breakthrough infections with 95% confidence intervals ([,]) were estimated by HIV status. Cox proportional hazards models estimated adjusted hazard ratios (aHR) of breakthrough infections by HIV status adjusting for demographic factors, prior COVID-19 illness, vaccine type (BNT162b2, [Pfizer], mRNA-1273 [Moderna], Jansen Ad26.COV2.S [J&J]), calendar time, and cohort. Risk factors for breakthroughs among PWH, were also investigated.ExposureHIV infectionOutcomeCOVID-19 breakthrough infections, defined as laboratory evidence of SARS-CoV-2 infection or COVID-19 diagnosis after an individual was fully vaccinated.ResultsAmong 109,599 individuals (31,840 PWH and 77,759 PWoH), the rate of breakthrough infections was higher in PWH versus PWoH: 44 [41, 48] vs. 31 [29, 33] per 1,000 person-years. Cumulative incidence at 210 days after date fully vaccinated was low, albeit higher in PWH versus PWoH overall (2.8% versus 2.1%, log-rank p<0.001, risk difference=0.7% [0.4%, 1.0%]) and within each vaccine type. Breakthrough infection risk was 41% higher in PWH versus PWoH (aHR=1.41 [1.28, 1.56]). Among PWH, younger age (18-24 versus 45-54), history of COVID-19 prior to fully vaccinated date, and J&J vaccination (versus Pfizer) were associated with increased risk of breakthroughs. There was no association of breakthrough with HIV viral load suppression or CD4 count among PWH.Conclusions and RelevanceCOVID-19 vaccination is effective against infection with SARS-CoV-2 strains circulating through 30 Sept 2021. PWH have an increased risk of breakthrough infections compared to PWoH. Recommendations for additional vaccine doses should be expanded to all PWH.

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Revealing HIV viral load patterns using unsupervised machine learning and cluster summarization

F1000Research ◽

10.12688/f1000research.15591.1 ◽

2018 ◽

Vol 7 ◽

pp. 1144

Author(s):

Samir A. Farooq ◽

Samuel J. Weisenthal ◽

Melissa Trayhan ◽

Robert J. White ◽

Kristen Bush ◽

...

Keyword(s):

Machine Learning ◽

Viral Load ◽

Clinical Decision Making ◽

Clinical Decision ◽

High Viral Load ◽

Outcome Variable ◽

Viral Load Suppression ◽

Hiv Viral Load ◽

Centroid Algorithm ◽

Meta Analyses

HIV RNA viral load (VL) is an important outcome variable in studies of HIV infected persons. There exists only a handful of methods which classify patients by VL patterns. Most methods place limits on the use of viral load measurements, are often specific to a particular study design, and do not account for complex, temporal variation. To address this issue, we propose a set of four unambiguous computable characteristics (features) of time-varying HIV viral load patterns, along with a novel centroid-based classification algorithm, which we use to classify a population of 1,576 HIV positive clinic patients into one of five different viral load patterns (clusters) often found in the literature: durably suppressed viral load (DSVL), sustained low viral load (SLVL), sustained high viral load (SHVL), high viral load suppression (HVLS), and rebounding viral load (RVL). The centroid algorithm summarizes these clusters in terms of their centroids and radii. We show that this allows new VL patterns to be assigned pattern membership based on the distance from the centroid relative to its radius, which we term radial normalization classification. This method has the benefit of providing an objective and quantitative method to assign VL pattern membership with a concise and interpretable model that aids clinical decision making. This method also facilitates meta-analyses by providing computably distinct HIV categories. Finally we propose that this novel centroid algorithm could also be useful in the areas of cluster comparison for outcomes research and data reduction in machine learning.

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