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Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?
The objective of this study was to evaluate the prevalence of blips and risk of virological failure (VF) among HIV-infected patients with sustained virological suppression (HIV-RNA
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| Published in: | Journal of antimicrobial chemotherapy 2016-04, Vol.71 (4), p.1051-1055 |
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| cites | cdi_FETCH-LOGICAL-c384t-848d96a4d6d9f4a3516556d423de9165f7088fec03809fd0ebba7f452e680013 |
| container_end_page | 1055 |
| container_issue | 4 |
| container_start_page | 1051 |
| container_title | Journal of antimicrobial chemotherapy |
| container_volume | 71 |
| creator | Pernas, Berta Grandal, Marta Pertega, Sonia Cañizares, Angelina Castro-Iglesias, Ángeles Mena, Álvaro Rodriguez-Osorio, Iria Tabernilla, Andrés Pedreira, José D Poveda, Eva |
| description | The objective of this study was to evaluate the prevalence of blips and risk of virological failure (VF) among HIV-infected patients with sustained virological suppression (HIV-RNA |
| doi_str_mv | 10.1093/jac/dkv433 |
| format | article |
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Newly diagnosed (2004-13) HIV-infected patients with sustained virological suppression on ART (minimum follow-up of 3 months) were identified. Risk of VF was evaluated according to different plasma HIV-RNA quantification values based on the limits of quantification/detection of current commercial assays (20 copies/mL). Kaplan-Meier and Cox proportional hazards models were used to compare the cumulative incidence of VF.
A total of 565 newly diagnosed HIV-infected patients were identified: 453 started ART and 354 achieved virological suppression. Prevalence of blips (isolated HIV-RNA ranging from 50 to 200 copies/mL) and VF (HIV-RNA ≥50 copies/mL) was 22.7% and 8.8%, respectively (mean follow-up of 42 months). Multivariate analysis identified differences between HIV-RNA values as an independent predictor of VF (P = 0.008); risk of VF was higher for patients with blips [HR 2.500 (95% CI 0.524-11.926)] and for those with at least three consecutive detected, but not quantified, HIV-RNA determinations (HIV-RNA <20 copies/mL) [HR 3.813 (95% CI 0.675-21.535)]. Moreover, only HIV-infected patients with at least three consecutive detected, but not quantified, HIV-RNA determinations showed a higher probability of virological rebound with >200 copies/mL [33.7% at 24 and 60 months versus <5% for other HIV-RNA values; HR 6.943 (0.728-66.261), P = 0.092].
Blips are frequent (22.7%) among HIV-infected patients with sustained virological suppression on ART. HIV patients with blips and at least three consecutive detected, but not quantified, HIV-RNA determinations (<20 copies/mL) had a higher risk of VF. These findings highlight the relevance of maintaining HIV-RNA levels below the limits of quantification of current assays (<20 copies/mL).</description><identifier>ISSN: 0305-7453</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/dkv433</identifier><identifier>PMID: 26702924</identifier><language>eng</language><publisher>England: Oxford Publishing Limited (England)</publisher><subject>Adult ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; CD4 Lymphocyte Count ; Coinfection ; Drug therapy ; Female ; HIV ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - virology ; Human immunodeficiency virus ; Humans ; Male ; Middle Aged ; Ribonucleic acid ; Risk assessment ; RNA ; Treatment Failure ; Treatment Outcome ; Viral Load ; Viremia ; Virology</subject><ispartof>Journal of antimicrobial chemotherapy, 2016-04, Vol.71 (4), p.1051-1055</ispartof><rights>The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.</rights><rights>Copyright Oxford Publishing Limited(England) Apr 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-848d96a4d6d9f4a3516556d423de9165f7088fec03809fd0ebba7f452e680013</citedby><cites>FETCH-LOGICAL-c384t-848d96a4d6d9f4a3516556d423de9165f7088fec03809fd0ebba7f452e680013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26702924$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pernas, Berta</creatorcontrib><creatorcontrib>Grandal, Marta</creatorcontrib><creatorcontrib>Pertega, Sonia</creatorcontrib><creatorcontrib>Cañizares, Angelina</creatorcontrib><creatorcontrib>Castro-Iglesias, Ángeles</creatorcontrib><creatorcontrib>Mena, Álvaro</creatorcontrib><creatorcontrib>Rodriguez-Osorio, Iria</creatorcontrib><creatorcontrib>Tabernilla, Andrés</creatorcontrib><creatorcontrib>Pedreira, José D</creatorcontrib><creatorcontrib>Poveda, Eva</creatorcontrib><title>Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>The objective of this study was to evaluate the prevalence of blips and risk of virological failure (VF) among HIV-infected patients with sustained virological suppression (HIV-RNA <50 copies/mL) on ART.
Newly diagnosed (2004-13) HIV-infected patients with sustained virological suppression on ART (minimum follow-up of 3 months) were identified. Risk of VF was evaluated according to different plasma HIV-RNA quantification values based on the limits of quantification/detection of current commercial assays (20 copies/mL). Kaplan-Meier and Cox proportional hazards models were used to compare the cumulative incidence of VF.
A total of 565 newly diagnosed HIV-infected patients were identified: 453 started ART and 354 achieved virological suppression. Prevalence of blips (isolated HIV-RNA ranging from 50 to 200 copies/mL) and VF (HIV-RNA ≥50 copies/mL) was 22.7% and 8.8%, respectively (mean follow-up of 42 months). Multivariate analysis identified differences between HIV-RNA values as an independent predictor of VF (P = 0.008); risk of VF was higher for patients with blips [HR 2.500 (95% CI 0.524-11.926)] and for those with at least three consecutive detected, but not quantified, HIV-RNA determinations (HIV-RNA <20 copies/mL) [HR 3.813 (95% CI 0.675-21.535)]. Moreover, only HIV-infected patients with at least three consecutive detected, but not quantified, HIV-RNA determinations showed a higher probability of virological rebound with >200 copies/mL [33.7% at 24 and 60 months versus <5% for other HIV-RNA values; HR 6.943 (0.728-66.261), P = 0.092].
Blips are frequent (22.7%) among HIV-infected patients with sustained virological suppression on ART. HIV patients with blips and at least three consecutive detected, but not quantified, HIV-RNA determinations (<20 copies/mL) had a higher risk of VF. These findings highlight the relevance of maintaining HIV-RNA levels below the limits of quantification of current assays (<20 copies/mL).</description><subject>Adult</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>CD4 Lymphocyte Count</subject><subject>Coinfection</subject><subject>Drug therapy</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ribonucleic acid</subject><subject>Risk assessment</subject><subject>RNA</subject><subject>Treatment Failure</subject><subject>Treatment Outcome</subject><subject>Viral Load</subject><subject>Viremia</subject><subject>Virology</subject><issn>0305-7453</issn><issn>1460-2091</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqN0c9r2zAUB3AxWpa022V_wBD0Ugpen60flk8jlK0NFAYj7GoU6zlVKkueZaf0sr-9Ckl36KkgkHj6vIfEl5AvOXzLoWLXW91cm8cdZ-wDmedcQlZAlZ-QOTAQWckFm5GzGLcAIIVUH8mskCUUVcHn5N_CP1Pb9boZaWjp2tk-Uu0NdeEpc7hDR3d20NhZTbG3MRhM913wG3q3_JNZ32IzoqG9Hi36MdInOz7QOMVRW5_qqTm4sLGNdqna9wPGaIOnaS1-r75_IqetdhE_H_dzsvr5Y3Vzl93_ul3eLO6zhik-ZoorU0nNjTRVyzUTuRRCGl4wg1U6tyUolV4CTEHVGsD1WpctFwVKBZCzc3J5GNsP4e-Ecaw7Gxt0TnsMU6zzUoki9ZbwDlruoRI80Ys3dBumwad_7FVZcFHJvbo6qGYIMQ7Y1v1gOz081znU-_zqlF99yC_hr8eR07pD85--BsZeACSWlt0</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Pernas, Berta</creator><creator>Grandal, Marta</creator><creator>Pertega, Sonia</creator><creator>Cañizares, Angelina</creator><creator>Castro-Iglesias, Ángeles</creator><creator>Mena, Álvaro</creator><creator>Rodriguez-Osorio, Iria</creator><creator>Tabernilla, Andrés</creator><creator>Pedreira, José D</creator><creator>Poveda, Eva</creator><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?</title><author>Pernas, Berta ; Grandal, Marta ; Pertega, Sonia ; Cañizares, Angelina ; Castro-Iglesias, Ángeles ; Mena, Álvaro ; Rodriguez-Osorio, Iria ; Tabernilla, Andrés ; Pedreira, José D ; Poveda, Eva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-848d96a4d6d9f4a3516556d423de9165f7088fec03809fd0ebba7f452e680013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>CD4 Lymphocyte Count</topic><topic>Coinfection</topic><topic>Drug therapy</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - virology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ribonucleic acid</topic><topic>Risk assessment</topic><topic>RNA</topic><topic>Treatment Failure</topic><topic>Treatment Outcome</topic><topic>Viral Load</topic><topic>Viremia</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pernas, Berta</creatorcontrib><creatorcontrib>Grandal, Marta</creatorcontrib><creatorcontrib>Pertega, Sonia</creatorcontrib><creatorcontrib>Cañizares, Angelina</creatorcontrib><creatorcontrib>Castro-Iglesias, Ángeles</creatorcontrib><creatorcontrib>Mena, Álvaro</creatorcontrib><creatorcontrib>Rodriguez-Osorio, Iria</creatorcontrib><creatorcontrib>Tabernilla, Andrés</creatorcontrib><creatorcontrib>Pedreira, José D</creatorcontrib><creatorcontrib>Poveda, Eva</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of antimicrobial chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pernas, Berta</au><au>Grandal, Marta</au><au>Pertega, Sonia</au><au>Cañizares, Angelina</au><au>Castro-Iglesias, Ángeles</au><au>Mena, Álvaro</au><au>Rodriguez-Osorio, Iria</au><au>Tabernilla, Andrés</au><au>Pedreira, José D</au><au>Poveda, Eva</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?</atitle><jtitle>Journal of antimicrobial chemotherapy</jtitle><addtitle>J Antimicrob Chemother</addtitle><date>2016-04</date><risdate>2016</risdate><volume>71</volume><issue>4</issue><spage>1051</spage><epage>1055</epage><pages>1051-1055</pages><issn>0305-7453</issn><eissn>1460-2091</eissn><abstract>The objective of this study was to evaluate the prevalence of blips and risk of virological failure (VF) among HIV-infected patients with sustained virological suppression (HIV-RNA <50 copies/mL) on ART.
Newly diagnosed (2004-13) HIV-infected patients with sustained virological suppression on ART (minimum follow-up of 3 months) were identified. Risk of VF was evaluated according to different plasma HIV-RNA quantification values based on the limits of quantification/detection of current commercial assays (20 copies/mL). Kaplan-Meier and Cox proportional hazards models were used to compare the cumulative incidence of VF.
A total of 565 newly diagnosed HIV-infected patients were identified: 453 started ART and 354 achieved virological suppression. Prevalence of blips (isolated HIV-RNA ranging from 50 to 200 copies/mL) and VF (HIV-RNA ≥50 copies/mL) was 22.7% and 8.8%, respectively (mean follow-up of 42 months). Multivariate analysis identified differences between HIV-RNA values as an independent predictor of VF (P = 0.008); risk of VF was higher for patients with blips [HR 2.500 (95% CI 0.524-11.926)] and for those with at least three consecutive detected, but not quantified, HIV-RNA determinations (HIV-RNA <20 copies/mL) [HR 3.813 (95% CI 0.675-21.535)]. Moreover, only HIV-infected patients with at least three consecutive detected, but not quantified, HIV-RNA determinations showed a higher probability of virological rebound with >200 copies/mL [33.7% at 24 and 60 months versus <5% for other HIV-RNA values; HR 6.943 (0.728-66.261), P = 0.092].
Blips are frequent (22.7%) among HIV-infected patients with sustained virological suppression on ART. HIV patients with blips and at least three consecutive detected, but not quantified, HIV-RNA determinations (<20 copies/mL) had a higher risk of VF. These findings highlight the relevance of maintaining HIV-RNA levels below the limits of quantification of current assays (<20 copies/mL).</abstract><cop>England</cop><pub>Oxford Publishing Limited (England)</pub><pmid>26702924</pmid><doi>10.1093/jac/dkv433</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of antimicrobial chemotherapy, 2016-04, Vol.71 (4), p.1051-1055 |
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| subjects | Adult Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Coinfection Drug therapy Female HIV HIV Infections - diagnosis HIV Infections - drug therapy HIV Infections - virology Human immunodeficiency virus Humans Male Middle Aged Ribonucleic acid Risk assessment RNA Treatment Failure Treatment Outcome Viral Load Viremia Virology |
| title | Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART? |
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