P86 An audit of time taken to reach undetectable viral load in therapy-naïve HIV-positive patients initiating art

Plasma HIV-1 RNA concentration, or viral load, is an indication of the magnitude of virus replication and largely correlates with disease progression in an infected person. It is a very useful guide for initiation of therapy and monitoring of response to antiretroviral drugs. Although the majority of patients who are not on antiretroviral therapy (ART) have a high viral load, a small proportion of ART naive patients are known to maintain low levels or even undetectable viral load levels. In this study, we determined the rate of undetectable HIV-1 RNA among ART naive HIV positive patients who presented for treatment at the University College Hospital (UCH), Ibadan, Nigeria from 2005 to 2011. Baseline viral load and CD4 lymphocyte cell counts of 14,662 HIV positive drug naive individuals were determined using the Roche Amplicor version 1.5 and Partec easy count kit, respectively. The detection limits of the viral load assay are 400 copies/mL and 750,000 copies/mL for lower and upper levels, respectively. A total of 1,399 of the 14,662 (9.5%) HIV-1 positive drug naive individuals had undetectable viral load during the study period. In addition, the rate of non-detectable viral load increased over the years. The mean CD4 counts among HIV-1 infected individuals with detectable viral load (266 cells/μL; range = 1 to 2,699 cells/μL) was lower than in patients with undetectable viral load (557 cells/μL; range = 1 to 3,102 cells/μL). About 10% of HIV-1 infected persons in our study population had undetectable viral load using the Roche Amplicor version 1.5.

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Association between atazanavir plasma levels and renal function in HIV-positive individuals on antiretroviral therapy with undetectable viral load

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2013.01.013 ◽

2013 ◽

Vol 41 (5) ◽

pp. 497-498

Author(s):

Ana Júlia Luz ◽

Júlia Poeta ◽

Rafael Linden ◽

Marina Venzon Antunes ◽

Luiza Isola Caminha ◽

...

Keyword(s):

Renal Function ◽

Viral Load ◽

Antiretroviral Therapy ◽

Plasma Levels ◽

Undetectable Viral Load ◽

Hiv Positive

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A Retrospective Study of the Management of HIV, Hepatitis B and Hepatitis C-Positive Pregnancies in Edinburgh, UK from 1997-2002.

McGill Journal of Medicine ◽

10.26443/mjm.v7i2.820 ◽

2004 ◽

Vol 7 (2) ◽

Author(s):

Wendy Russell

Keyword(s):

Viral Load ◽

Management Practices ◽

Tracking System ◽

Undetectable Viral Load ◽

Hiv Positive ◽

Hiv Therapy ◽

Hiv Positive Women ◽

Valid Data ◽

Study Child ◽

Intrapartum Management

STUDY AIMS: This study aims to examine management practices for HIV-positive, HBV-positive and HCV-positive pregnancies over 1997-2002 in Edinburgh, UK, and the effects the diseases have on pregnancy outcomes. RESULTS: Equally for HIV, HBV, and HCV, 50% of the diagnoses were made before pregnancy while the other 50% were detected and diagnosed through antenatal testing. Of the 17 HBV-positive pregnancies 31.6% of the women were highly infectious at delivery and 57.9% were carriers with low infectivity. Of the 17 HIV-positive pregnancies 47.1% of the women had an undetectable viral load and 17.6% were unrecorded at delivery. All 17 HIV-positive pregnancies received ART in varying regimes, 15 (88.2%) were on combination therapy, one delivered vaginally and no women breastfed. All neonates of HBV-positive mothers received immunoglobulin and vaccination and were then breastfed. There were no specific interventions for HCV. Only one study child out of the 38 pregnancies became infected, and this was with HIV. CONCLUSION: Routine screening identifies women with no obvious risk factors, and interventions are largely accepted and effective at reducing vertical transmission. HIV therapy is individually tailored and increasingly uses several agents. Moreover, there is a movement towards allowing low viral load HIV-positive women to deliver vaginally. There are no interventions recommended for HCV infectivity alone. The difficulty collecting information illustrates that no adequate tracking system of infected pregnant women exists. Recommended is the creation of a formal database that includes standardized information such as the viral load of HIV or HCV at delivery, so that outcomes of intrapartum management can be more effectively assessed. No comment can be made on virus-related pregnancy complications, as study numbers are too small for statistically valid data.

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Virological Response in Cerebrospinal Fluid to Antiretroviral Therapy in a Large Italian Cohort of HIV-Infected Patients with Neurological Disorders

AIDS Research and Treatment ◽

10.1155/2012/708456 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Maria Letizia Giancola ◽

Patrizia Lorenzini ◽

Antonella Cingolani ◽

Francesco Baldini ◽

Simona Bossolasco ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Viral Load ◽

Neurological Disorders ◽

Undetectable Viral Load ◽

Antiretroviral Drugs ◽

Hiv Positive ◽

Hiv Replication ◽

Hiv Rna ◽

Neuroactive Drugs ◽

Italian Cohort

The aim of the present study was to analyse the effect of antiretroviral (ARV) therapy and single antiretroviral drugs on cerebrospinal fluid (CSF) HIV-RNA burden in HIV-infected patients affected by neurological disorders enrolled in a multicentric Italian cohort. ARVs were considered “neuroactive” from literature reports. Three hundred sixty-three HIV-positive patients with available data from paired plasma and CSF samples, were selected. One hundred twenty patients (33.1%) were taking ARVs at diagnosis of neurological disorder. Mean CSF HIV-RNA was significantly higher in naïve than in experienced patients, and in patients not taking ARV than in those on ARV. A linear correlation between CSF HIV-RNA levels and number of neuroactive drugs included in the regimen was also found (r=−0.44,P<0.001). Low -plasma HIV-RNA and the lack of neurocognitive impairment resulted in independently associated to undetectable HIV-RNA. Taking nevirapine or efavirenz, or regimen including NNRTI, NNRTI plus PI or boosted PI, was independently associated to an increased probability to have undetectable HIV-RNA in CSF. The inclusion of two or three neuroactive drugs in the ARV regimen was independently associated to undetectable viral load in CSF. Our data could be helpful in identifying ARV regimens able to better control HIV replication in the CNS sanctuary, and could be a historical reference for further analyses.

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An unexpected undetectable viral load in a vulnerable woman

International Journal of STD & AIDS ◽

10.1258/ijsa.2011.011335 ◽

2012 ◽

Vol 23 (7) ◽

pp. 531-532

Author(s):

G Fraser ◽

F Fargie

Keyword(s):

Viral Load ◽

Undetectable Viral Load ◽

Significant Rise ◽

African Woman ◽

Hiv Positive ◽

Treatment Level ◽

Elite Controllers ◽

Hiv Viral Load ◽

Recommended Treatment ◽

History Of

We present a case of a vulnerable HIV-positive African woman who on initial visits to the clinic had an undetectable HIV viral load without giving a history of being on antiretroviral therapy (ART) who then had an abrupt and significant rise in viral load and fall in CD4 count to below the recommended treatment level of 350 cells/μL. She gave a history of having been given a ‘white tablet’ from the man who had trafficked her. As genuine ‘elite controllers’ are rare and do not usually follow this pattern, we suspect that this woman was unknowingly on ART.

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Barriers to achieving undetectable viral load in HIV-positive pregnant women at the time of delivery: The Swiss Mother & Child HIV Cohort Study

Zeitschrift für Geburtshilfe und Neonatologie ◽

10.1055/s-0033-1361427 ◽

2013 ◽

Vol 217 (S 01) ◽

Author(s):

K Aebi-Popp ◽

T Glass ◽

C Rudin ◽

B Bertisch ◽

B Martinez de Tejada ◽

...

Keyword(s):

Cohort Study ◽

Viral Load ◽

Pregnant Women ◽

Undetectable Viral Load ◽

Hiv Positive

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Estimating antiretroviral treatment coverage rates and viral suppression rates for homosexual men in Australia

Sexual Health ◽

10.1071/sh15037 ◽

2015 ◽

Vol 12 (5) ◽

pp. 453 ◽

Cited By ~ 6

Author(s):

Nicole L. De La Mata ◽

Limin Mao ◽

John De Wit ◽

Don Smith ◽

Martin Holt ◽

...

Keyword(s):

Viral Load ◽

Antiretroviral Treatment ◽

Viral Suppression ◽

Undetectable Viral Load ◽

Hiv Positive ◽

Community Based ◽

Study Objective ◽

Hiv Epidemic ◽

Sex With Men ◽

Coverage Rates

Gay and other men who have sex with men (GMSM) are disproportionally affected by the HIV epidemic in Australia. The study objective is to combine a clinical-based cohort with a community-based surveillance system to present a broader representation of the GMSM community to determine estimates of proportions receiving antiretroviral therapy (ART) and/or with an undetectable viral load. Between 2010 and 2012, small increases were shown in ART uptake (to 70.2%) and proportions with undetectable viral load (to 62.4%). The study findings highlight the potential for significantly increasing ART uptake among HIV-positive GMSM to reduce the HIV epidemic in Australia.

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Evaluation of rates of virologic suppression in HIV-positive patients with varying numbers of comorbidities

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxab346 ◽

2021 ◽

Author(s):

Briann Fischetti ◽

Maria Sorbera ◽

Rebecca Michael, ◽

Noor Njeim

Keyword(s):

Viral Load ◽

Psychiatric Disorders ◽

Viral Suppression ◽

Undetectable Viral Load ◽

Secondary Outcome ◽

Hiv Positive ◽

Virologic Suppression ◽

Care Clinic ◽

Viral Loads ◽

The Impact

Abstract Purpose To evaluate the impact of the number of comorbidities on virologic suppression in HIV-positive patients. Methods This study included patients 18 years or older who were on antiretroviral therapy (ART) with at least 2 visits to an HIV primary care clinic in the past year. The primary outcome was the percentage of patients with an undetectable viral load (a blood HIV RNA level of <20 copies/mL) among groups of patients with 0, 1 or 2, 3 or 4, and 5 comorbidities, respectively. The secondary outcome was the percentage of patients with undetectable viral loads per each comorbidity, as listed above. The study was reviewed by an institutional review board and approved as exempt from full review. Results Among the 1,144 patients (median age of 52 years, 43% female, 74% Black) included in the study, 80% had an undetectable viral load, and the mean CD4 count was 638 cells/mm3. The majority of patients (48%) had 1 or 2 comorbidities, with only 2 patients having 5 comorbidities. For patients with 0, 1 or 2, 3 or 4, and 5 comorbidities, the percentages of patients with undetectable HIV viral loads were 76%, 81.7%, 87.9%, and 100%, respectively (P = 0.0009 in χ 2 test for trend). When looking at individual comorbidities, corresponding viral suppression rates were as follows: chronic kidney disease, 88.6%; hypertension, 85.8%; type 2 diabetes, 85.7%; clinical atherosclerotic cardiovascular disease, 83.1%; substance abuse, 76%; and psychiatric disorders, 75.2%. Conclusion Improved viral suppression was seen among HIV-positive patients with an increased number of comorbidities. Patients with psychiatric disorders had the lowest viral suppression rates amongst all of the comorbidity subgroups.

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