Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

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Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients. / Vandenhende, Marie-Anne; Ingle, Suzanne; May, Margaret; Chene, Geneviève; Zangerle, Robert; Van Sighem, Ard; Gill, M John; Schwarze-Zander, Carolynne; Hernandez-Novoa, Beatriz; Obel, Niels; Kirk, Ole; Abgrall, Sophie; Guest, Jodie; Samji, Hasina; D'Arminio Monforte, Antonella; Llibre, Josep M; Smith, Colette; Cavassini, Matthias; Burkholder, Greer A; Shepherd, Bryan; Crane, Heidi M; Sterne, Jonathan; Morlat, Philippe; Antiretroviral Therapy Cohort Collaboration (ART-CC).

I: AIDS (London, England), Bind 29, Nr. 3, 28.01.2015, s. 373-83.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Vandenhende, M-A, Ingle, S, May, M, Chene, G, Zangerle, R, Van Sighem, A, Gill, MJ, Schwarze-Zander, C, Hernandez-Novoa, B, Obel, N, Kirk, O, Abgrall, S, Guest, J, Samji, H, D'Arminio Monforte, A, Llibre, JM, Smith, C, Cavassini, M, Burkholder, GA, Shepherd, B, Crane, HM, Sterne, J, Morlat, P & Antiretroviral Therapy Cohort Collaboration (ART-CC) 2015, 'Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients', AIDS (London, England), bind 29, nr. 3, s. 373-83. https://doi.org/10.1097/QAD.0000000000000544

APA

Vandenhende, M-A., Ingle, S., May, M., Chene, G., Zangerle, R., Van Sighem, A., ... Antiretroviral Therapy Cohort Collaboration (ART-CC) (2015). Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients. AIDS (London, England), 29(3), 373-83. https://doi.org/10.1097/QAD.0000000000000544

Vancouver

Vandenhende M-A, Ingle S, May M, Chene G, Zangerle R, Van Sighem A o.a. Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients. AIDS (London, England). 2015 jan 28;29(3):373-83. https://doi.org/10.1097/QAD.0000000000000544

Author

Vandenhende, Marie-Anne ; Ingle, Suzanne ; May, Margaret ; Chene, Geneviève ; Zangerle, Robert ; Van Sighem, Ard ; Gill, M John ; Schwarze-Zander, Carolynne ; Hernandez-Novoa, Beatriz ; Obel, Niels ; Kirk, Ole ; Abgrall, Sophie ; Guest, Jodie ; Samji, Hasina ; D'Arminio Monforte, Antonella ; Llibre, Josep M ; Smith, Colette ; Cavassini, Matthias ; Burkholder, Greer A ; Shepherd, Bryan ; Crane, Heidi M ; Sterne, Jonathan ; Morlat, Philippe ; Antiretroviral Therapy Cohort Collaboration (ART-CC). / Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients. I: AIDS (London, England). 2015 ; Bind 29, Nr. 3. s. 373-83.

Bibtex

@article{b284b393489d4121907bb01a91ead3a9,
title = "Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients",
abstract = "BACKGROUND: The goal of antiretroviral therapy (ART) is to reduce HIV-related morbidity and mortality by suppressing HIV replication. The prognostic value of persistent low-level viremia (LLV), particularly for clinical outcomes, is unknown.OBJECTIVE: Assess the association of different levels of LLV with virological failure, AIDS event, and death among HIV-infected patients receiving combination ART.METHODS: We analyzed data from 18 cohorts in Europe and North America, contributing to the ART Cohort Collaboration. Eligible patients achieved viral load below 50  copies/ml within 3-9 months after ART initiation. LLV50-199 was defined as two consecutive viral loads between 50 and 199  copies/ml and LLV200-499 as two consecutive viral loads between 50 and 499  copies/ml, with at least one between 200 and 499  copies/ml. We used Cox models to estimate the association of LLV with virological failure (two consecutive viral loads at least 500  copies/ml or one viral load at least 500 copies/ml, followed by a modification of ART) and AIDS event/death.RESULTS: Among 17 902 patients, 624 (3.5{\%}) experienced LLV50-199 and 482 (2.7{\%}) LLV200-499. Median follow-up was 2.3 and 3.1 years for virological and clinical outcomes, respectively. There were 1903 virological failure, 532 AIDS events and 480 deaths. LLV200-499 was strongly associated with virological failure [adjusted hazard ratio (aHR) 3.97, 95{\%} confidence interval (CI) 3.05-5.17]. LLV50-199 was weakly associated with virological failure (aHR 1.38, 95{\%} CI 0.96-2.00). LLV50-199 and LLV200-499 were not associated with AIDS event/death (aHR 1.13, 95{\%} CI 0.81-1.68; and aHR 0.95, 95{\%} CI 0.62-1.48, [corrected] respectively).CONCLUSION: LLV200-499 was strongly associated with virological failure, but not with AIDS event/death. Our results support the US guidelines, which define virological failure as a confirmed viral load above 200  copies/ml.",
keywords = "Adult, Anti-Retroviral Agents, Antiretroviral Therapy, Highly Active, Europe, Female, HIV Infections, HIV-1, Humans, Male, Middle Aged, North America, Prognosis, Survival Analysis, Treatment Outcome, Viral Load, Viremia",
author = "Marie-Anne Vandenhende and Suzanne Ingle and Margaret May and Genevi{\`e}ve Chene and Robert Zangerle and {Van Sighem}, Ard and Gill, {M John} and Carolynne Schwarze-Zander and Beatriz Hernandez-Novoa and Niels Obel and Ole Kirk and Sophie Abgrall and Jodie Guest and Hasina Samji and {D'Arminio Monforte}, Antonella and Llibre, {Josep M} and Colette Smith and Matthias Cavassini and Burkholder, {Greer A} and Bryan Shepherd and Crane, {Heidi M} and Jonathan Sterne and Philippe Morlat and {Antiretroviral Therapy Cohort Collaboration (ART-CC)}",
year = "2015",
month = "1",
day = "28",
doi = "10.1097/QAD.0000000000000544",
language = "English",
volume = "29",
pages = "373--83",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams & Wilkins",
number = "3",

}

RIS

TY - JOUR

T1 - Impact of low-level viremia on clinical and virological outcomes in treated HIV-1-infected patients

AU - Vandenhende, Marie-Anne

AU - Ingle, Suzanne

AU - May, Margaret

AU - Chene, Geneviève

AU - Zangerle, Robert

AU - Van Sighem, Ard

AU - Gill, M John

AU - Schwarze-Zander, Carolynne

AU - Hernandez-Novoa, Beatriz

AU - Obel, Niels

AU - Kirk, Ole

AU - Abgrall, Sophie

AU - Guest, Jodie

AU - Samji, Hasina

AU - D'Arminio Monforte, Antonella

AU - Llibre, Josep M

AU - Smith, Colette

AU - Cavassini, Matthias

AU - Burkholder, Greer A

AU - Shepherd, Bryan

AU - Crane, Heidi M

AU - Sterne, Jonathan

AU - Morlat, Philippe

AU - Antiretroviral Therapy Cohort Collaboration (ART-CC)

PY - 2015/1/28

Y1 - 2015/1/28

N2 - BACKGROUND: The goal of antiretroviral therapy (ART) is to reduce HIV-related morbidity and mortality by suppressing HIV replication. The prognostic value of persistent low-level viremia (LLV), particularly for clinical outcomes, is unknown.OBJECTIVE: Assess the association of different levels of LLV with virological failure, AIDS event, and death among HIV-infected patients receiving combination ART.METHODS: We analyzed data from 18 cohorts in Europe and North America, contributing to the ART Cohort Collaboration. Eligible patients achieved viral load below 50  copies/ml within 3-9 months after ART initiation. LLV50-199 was defined as two consecutive viral loads between 50 and 199  copies/ml and LLV200-499 as two consecutive viral loads between 50 and 499  copies/ml, with at least one between 200 and 499  copies/ml. We used Cox models to estimate the association of LLV with virological failure (two consecutive viral loads at least 500  copies/ml or one viral load at least 500 copies/ml, followed by a modification of ART) and AIDS event/death.RESULTS: Among 17 902 patients, 624 (3.5%) experienced LLV50-199 and 482 (2.7%) LLV200-499. Median follow-up was 2.3 and 3.1 years for virological and clinical outcomes, respectively. There were 1903 virological failure, 532 AIDS events and 480 deaths. LLV200-499 was strongly associated with virological failure [adjusted hazard ratio (aHR) 3.97, 95% confidence interval (CI) 3.05-5.17]. LLV50-199 was weakly associated with virological failure (aHR 1.38, 95% CI 0.96-2.00). LLV50-199 and LLV200-499 were not associated with AIDS event/death (aHR 1.13, 95% CI 0.81-1.68; and aHR 0.95, 95% CI 0.62-1.48, [corrected] respectively).CONCLUSION: LLV200-499 was strongly associated with virological failure, but not with AIDS event/death. Our results support the US guidelines, which define virological failure as a confirmed viral load above 200  copies/ml.

AB - BACKGROUND: The goal of antiretroviral therapy (ART) is to reduce HIV-related morbidity and mortality by suppressing HIV replication. The prognostic value of persistent low-level viremia (LLV), particularly for clinical outcomes, is unknown.OBJECTIVE: Assess the association of different levels of LLV with virological failure, AIDS event, and death among HIV-infected patients receiving combination ART.METHODS: We analyzed data from 18 cohorts in Europe and North America, contributing to the ART Cohort Collaboration. Eligible patients achieved viral load below 50  copies/ml within 3-9 months after ART initiation. LLV50-199 was defined as two consecutive viral loads between 50 and 199  copies/ml and LLV200-499 as two consecutive viral loads between 50 and 499  copies/ml, with at least one between 200 and 499  copies/ml. We used Cox models to estimate the association of LLV with virological failure (two consecutive viral loads at least 500  copies/ml or one viral load at least 500 copies/ml, followed by a modification of ART) and AIDS event/death.RESULTS: Among 17 902 patients, 624 (3.5%) experienced LLV50-199 and 482 (2.7%) LLV200-499. Median follow-up was 2.3 and 3.1 years for virological and clinical outcomes, respectively. There were 1903 virological failure, 532 AIDS events and 480 deaths. LLV200-499 was strongly associated with virological failure [adjusted hazard ratio (aHR) 3.97, 95% confidence interval (CI) 3.05-5.17]. LLV50-199 was weakly associated with virological failure (aHR 1.38, 95% CI 0.96-2.00). LLV50-199 and LLV200-499 were not associated with AIDS event/death (aHR 1.13, 95% CI 0.81-1.68; and aHR 0.95, 95% CI 0.62-1.48, [corrected] respectively).CONCLUSION: LLV200-499 was strongly associated with virological failure, but not with AIDS event/death. Our results support the US guidelines, which define virological failure as a confirmed viral load above 200  copies/ml.

KW - Adult

KW - Anti-Retroviral Agents

KW - Antiretroviral Therapy, Highly Active

KW - Europe

KW - Female

KW - HIV Infections

KW - HIV-1

KW - Humans

KW - Male

KW - Middle Aged

KW - North America

KW - Prognosis

KW - Survival Analysis

KW - Treatment Outcome

KW - Viral Load

KW - Viremia

U2 - 10.1097/QAD.0000000000000544

DO - 10.1097/QAD.0000000000000544

M3 - Journal article

C2 - 25686685

VL - 29

SP - 373

EP - 383

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 3

ER -

ID: 161725455