Sklar P, Ward D, Baker R, Wood K, Gafoor Z, Alzola C, Moorman A, Holmberg S; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 8th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 8th 2001 Chic Ill. 2001 Feb 4-8; 8: 171 (abstract no. 431).

George Washington Univ.

Background: Many patients who achieve viral suppression below the limits of quantification (BLQ) (<50 copies/ml) on antiretroviral therapy (ART) have measurable viremia subsequently. To examine the prevalence and clinical correlates of this phenomenon outside of clinical trials, data was culled from the HOPS, a dynamic cohort seen at 9 HIV clinics (7 private, 2 public) in 7 U.S. cities between 1/1/97 and 6/30/00. Methods: Patients who had 2 consecutive HIV-1 RNA levels <50 (minimum, 2 mos apart) were followed while remaining on the same ART. Transiently viremic patients were defined as those with subsequent measurable viremia ("blips") who again achieved suppression BLQ. Lasting "rebound" viremic patients were those who did not return BLQ during the study period. Results: 481 patients were followed a mean of 517 days. Of these, 122 (25.4%) had transient viremia; 94/122 (77.0%) instances were low-level (50-400). Transient viremia occurred similarly in 21.8% of 87 previously ART-naive vs. 26.1% of 394 ART-experienced patients, p = 0.40; and in 25.5% of 377 on PI regimens vs. 25.0% of 104 on non-PI regimens, p = 0.92. No transiently viremic patients later had rebounded >400, but 16/122 (13.1%) later had viremia between 50-400. Of all 481 patients, 18 (3.7%) had lasting viremia >400. Evaluated individually, 51.2% of viremic patients had RNA levels BLQ on the following measurement. The median 1st detectable RNA level was 96 among transiently viremic patients vs. 201 among the lasting viremic patients, p = 0.0004. On consistent ART, the % increase in CD4 count was highest amongst transiently viremic patients (69.5) vs. those who remained suppressed BLQ (55.2) vs. those with low (50-400) and high (>400) lasting viremia (43.6, 16.3), p = 0.02. Conclusions: Transient detectable viremia, usually between 50-400, is common in patients with viral loads BLQ remaining on the same ART. CD4 count response to ART, but neither ART experience nor PI regimen use, was correlated with this phenomenon. Only a small proportion of patients have lasting viremia >400 requiring adjustments in their ART.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• CD4 Lymphocyte Count
• HIV
• HIV Infections
• Health Personnel
• Humans
• Prevalence
• United States
• Viral Load
• Viremia
• epidemiology
• psychology
• virology

Other ID:

• GWAIDS0006718

UI: 102244214

From Meeting Abstracts