Published in

BioMed Central, BMC Infectious Diseases, 1(15), 2015

DOI: 10.1186/s12879-015-1120-8

Links

Tools

Export citation

Search in Google Scholar

Transient detectable viremia and the risk of viral rebound in patients from the Swiss HIV Cohort Study

Journal article published in 2015 by Jim Young ORCID, E. Bernasconi, M. Battegay, A. Calmy, Cornelia Staehelin, Aubert, Enos Bernasconi, H. C. Bucher, Alexandra Calmy, M. Cavassini, J. Böni, C. Burton-Jeangros, H. F. Günthard, Manuel Battegay, G. Dollenmaier and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Upload
Green circle
Postprint: archiving allowed
Upload
Green circle
Published version: archiving allowed
Upload
Policy details
Data provided by SHERPA/RoMEO

Abstract

Abstract Background 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. Methods 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. Results 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. Conclusions 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.