Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?

Pernas, Berta; Grandal, Marta; Pértega, Sonia; Cañizares, Angelina; Castro‐Iglesias, Ángeles; Mena, Álvaro; Rodríguez-Osorio, Iria; Tabernilla, Andrés; Pedreira, José; Poveda, Eva

doi:10.1093/jac/dkv433

Cited by 29 publications

(33 citation statements)

References 17 publications

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“…In United States and some other resource-rich countries [10][11][12], LLV is defined as a VL between 50 and 200 copies/ml according to the Department of Health and Human Services (DHHS) guidelines (USA, 2016) [13]. In Europe and most resource-rich settings [14,15], LLV is defined as a VL between 20 and 50 copies/ml, according to the European acquired immune deficiency syndrome (AIDS) Clinical Society (EACS) guidelines [16]. Although LLV frequently occurs during treatment, none of the guidelines suggest changing the treatment regimen or intensifying treatment in case of LLV.…”

Section: Introductionmentioning

confidence: 99%

“…An earlier national observational cohort study from USA found that an LLV above 400 copies/ml could not predict AIDS or death [17]. However, multiple recent cohort studies worldwide demonstrated that the level of LLV is a determinant of prognosis; high level of LLV (> 200 copies/ml) occurring only once might increase the risk of virologic failure (VF) [7,14,18]. Some studies from developed countries found that persistent LLV or frequently occurring LLV of 50-200 copies/ml also increased the risk of VF [6,19,20].…”

Section: Introductionmentioning

confidence: 99%

“…However, a recent multicenter study from South Africa found that LLV below 200 copies/ml, whether continuous or not, contributed to increased VF risk [2]. Moreover, several recent studies found that even very low levels of pLLV between 20 and 50 copies/ml could predict an increased risk of viral failure [14,21]. Most of the above studies varied in their standards of LLV or VF definitions, and in some studies, the definition of VF was not stringent.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Zhang

Ding

et al. 2020

BMC Infect Dis

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Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, whether LLV increases the risk of virologic failure (VF) is controversial because of the non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002 to 2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.7% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HLB) showed higher risk of VF (hazards ratios, HR HLLV = 5.93, and HR HLB = 2.84, p < 0.05 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR = 3.49, p = 0.002), nadir baseline CD4 + T cell counts below 200 cells/mm 3 (aOR = 1.78, p = 0.011), Manchu (aOR = 2.03, p = 0.003), ART over 60 months (aOR = 1.81, p = 0.004), AZT + 3TC + NVP (aOR = 2.26, p < 0.001) or DDI-based regimen (aOR = 9.96, p = 0.002), and subtype B′ infection (aOR = 8.22, p = 0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B′ infection might also predict the occurrence of high-risk LLV.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Zhang

Ding

et al. 2020

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…In United States and some other resource-rich countries 10-12 , LLV is defined as a VL between 50-200 copies/ml according to the Department of Health and Human Services (DHHS) guidelines (USA, 2016) 13 . In Europe and most resource-rich settings 14,15 , LLV is defined as a VL between 20-50 copies/ml, according to the European acquired immune deficiency syndrome (AIDS) Clinical Society (EACS) guidelines 16 . Although LLV frequently occurs during treatment, none of the guidelines suggest changing the treatment regimen or intensifying treatment in case of LLV.…”

mentioning

confidence: 99%

“…An earlier national observational cohort study from USA found that an LLV above 400 copies/ml could not predict AIDS or death 17 . However, multiple recent cohort studies worldwide demonstrated that the level of LLV is a determinant of prognosis; high level of LLV (> 200 copies/ml) occurring only once might increase the risk of virologic failure (VF) 7, 14,18 . Some studies from developed countries found that persistent LLV or frequently occurring LLV of 50-200 copies/ml also increased the risk of VF 6, 19,20 .…”

mentioning

confidence: 99%

Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Zhang¹,

Ding²,

An³

et al. 2020

Preprint

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Background: Low level viremia (LLV) often occurs during antiretroviral therapy (ART) against HIV-1. However, whether LLV increases the risk of virologic failure (VF) is controversial because of the non-uniform definitions of LLV and VF. Methods: A long-term first line regimen ART cohort from 2002–2018 from Shenyang, northeast China, was retrospectively studied. All participants were followed up every 3 to 6 months to evaluate the treatment effect. The high-risk LLV subgroups leading to VF (with strict standards) were explored with Cox proportional hazards model and linear mixed-effect model. The association factors of high-risk LLV were further explored using multivariate logistic regression analyses. Results: A total of 2155 HIV-1 infected participants were included; of these, 38.7% showed LLV. Both high level LLV (HLLV) and any other level LLV coupled with high level blip (HLB) showed higher risk of VF (hazards ratios, HRHLLV=5.93, and HRHLB=2.84, p<0.05 respectively). Moreover, HR increased with prolonged duration of LLV. Independent factors associated with high-risk LLV included the zenith baseline viral load (VL) above 6 log copies/ml (aOR=3.49, p=0.002), nadir baseline CD4+T cell counts below 200 cells/mm3 (aOR=1.78, p=0.011), Manchu (aOR=2.03, p=0.003), ART over 60 months (aOR=1.81, p=0.004), AZT+3TC+NVP (aOR=2.26, p<0.001) or DDI-based regimen (aOR=9.96, p=0.002), and subtype B’ infection (aOR=8.22, p=0.001). Conclusions: In case of VF with strict standards, high-risk LLV leading to VF includes VL above 400 copies/ml, occurring at least once. Serious laboratory indicators or advanced stage of infection, long term ART and subtype B’ infection might also predict the occurrence of high-risk LLV.

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Deep Phenotyping of HIV Neurocognitive Complications Among Individuals Residing in High-Income Countries

Paul

García-Egan

Bolzenius

et al. 2020

Neurocognitive Complications of HIV-Infection

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Any impact of blips and low-level viraemia episodes among HIV-infected patients with sustained virological suppression on ART?

Cited by 29 publications

References 17 publications

Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Factors associated with high-risk low-level viremia leading to virologic failure: 16-year retrospective study of a Chinese antiretroviral therapy cohort

Deep Phenotyping of HIV Neurocognitive Complications Among Individuals Residing in High-Income Countries

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