Threefold Increases in Population HIV Viral Load Suppression Among Men and Young Adults — Bukoba Municipal Council, Tanzania, 2014–2017

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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Long-term durability of HIV viral load suppression

The Lancet HIV ◽

10.1016/s2352-3018(17)30063-2 ◽

2017 ◽

Vol 4 (7) ◽

pp. e279-e280 ◽

Cited By ~ 3

Author(s):

Nila J Dharan ◽

David A Cooper

Keyword(s):

Viral Load ◽

Viral Load Suppression ◽

Hiv Viral Load

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What gaps remain in the HIV cascade of care? Results of a population-based survey in Nsanje District, Malawi

PLoS ONE ◽

10.1371/journal.pone.0248410 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0248410

Author(s):

Nolwenn Conan ◽

Cyrus P. Paye ◽

Reinaldo Ortuno ◽

Alexander Chijuwa ◽

Brown Chiwandira ◽

...

Keyword(s):

Young Adults ◽

Viral Load ◽

Health Facility ◽

Population Based ◽

Hiv Care ◽

Hiv Positive ◽

Viral Load Suppression ◽

Hiv Rna ◽

Hiv Test ◽

Cascade Of Care

Introduction The Malawi Ministry of Health (MoH) has been in collaboration with Médecins sans Frontières (MSF) to increase access to quality HIV care through decentralization of antiretroviral therapy (ART) diagnosis and treatment from hospital to clinics in Nsanje District since 2011. A population-based household survey was implemented to provide information on HIV prevalence and cascade of care to inform and prioritize community-based HIV interventions in the district. Methods A cross-sectional survey was conducted between September 2016 and January 2017. Using two-stage cluster sampling, eligible adult individuals aged ≥15 years living in the selected households were asked to participate. Participants were interviewed and tested for HIV at home. Those tested HIV-positive had their HIV-RNA viral load (VL) measured, regardless of their ART status. All participants tested HIV-positive at the time of the survey were advised to report their HIV test result to the health facility of their choice that MSF was supported in the district. HIV-RNA VL results were made available in this health facility. Results Among 5,315 eligible individuals, 91.1% were included in the survey and accepted an HIV test. The overall prevalence was 12.1% (95% Confidence Interval (CI): 11.2–13.0) and was higher in women than in men: 14.0% versus 9.5%, P<0.001. Overall HIV-positive status awareness was 80.0% (95%CI: 76.4–83.1) and was associated with sex (P<0.05). Linkage to care was 78.0% (95%CI: 74.3–81.2) and participants in care 76.2% (95%CI: 72.4–79.5). ART coverage among participants aware of their HIV-positive status was 95.3% (95%CI: 92.9–96.9) and was not associated with sex (P = 0.55). Viral load suppression among participants on ART was 89.9% (95%CI: 86.6–92.4) and was not statistically different by sex (p = 0.40). Conclusions Despite encouraging results in HIV testing coverage, cascade of care, and UNAIDS targets in Nsanje District, some gap remains in the first 90, specifically among men and young adults. Enhanced community engagement and new strategies of testing, such as index testing, could be implemented to identify those who are still undiagnosed, particularly men and young adults.

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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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