Factors Associated with Low-Level Viraemia and Virological Failure: Results from the Austrian HIV Cohort Study: e0142923

• Published in: PloS one 2015-11, Vol.10 (11)
• Main Authors: Leierer, Gisela, Grabmeier-Pfistershammer, Katharina, Steuer, Andrea, Geit, Maria, Sarcletti, Mario, Haas, Bernhard, Kanatschnig, Manfred, Rappold, Michaela, Zangerle, Robert, Ledergerber, Bruno
• Format: Article
• Language: English
• Subjects: Human immunodeficiency virus
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0142923

Background In human immunodeficiency virus treatment adequate virological suppression is warranted, nevertheless for some patients it remains a challenge. We investigated factors associated with low-level viraemia (LLV) and virological failure (VF) under combined antiretroviral therapy (cART). Materials and Methods We analysed patients receiving standard regimens between 1st July 2012 and 1st July 2013 with at least one viral load (VL) measurement below the quantification limit (BLQ) in their treatment history. After a minimum of 6 months of unmodified cART, the next single VL measurement within 6 months was analysed. VF was defined as HIV RNA levels greater than or equal to 200 copies/mL and all other quantifiable measurements were classified as LLV. Factors associated with LLV and VF compared to BLQ were identified by logistic regression models. Results Of 2276 participants, 1972 (86.6%) were BLQ, 222 (9.8%) showed LLV and 82 (3.6%) had VF. A higher risk for LLV and VF was shown in patients with cART interruptions and in patients with boosted PI therapy. The risk for LLV and VF was lower in patients from centres using the Abbott compared to the Roche assay to measure VL. A higher risk for LLV but not for VF was found in patients with a higher VL before cART [for >99.999 copies/mL: aOR (95% CI): 4.19 (2.07-8.49); for 10.000-99.999 copies/mL: aOR (95% CI): 2.52 (1.23-5.19)] and shorter cART duration [for