Advertisement

 

 

Single Viral Load Measurements Overestimate Stable Viral Suppression among HIV Patients in Care: Clinical and Public Health Implications.

Author Information (click to view)

Marks G, Patel U, Stirratt MJ, Mugavero MJ, Mathews WC, Giordano TP, Crepaz N, Gardner LI, Grossman C, Davila J, Sullivan M, Rose CE, O'Daniels C, Rodriguez A, Wawrzyniak AJ, Golden MR, Dhanireddy S, Ellison J, Drainoni ML, Metsch LR, Cachay ER,


Marks G, Patel U, Stirratt MJ, Mugavero MJ, Mathews WC, Giordano TP, Crepaz N, Gardner LI, Grossman C, Davila J, Sullivan M, Rose CE, O'Daniels C, Rodriguez A, Wawrzyniak AJ, Golden MR, Dhanireddy S, Ellison J, Drainoni ML, Metsch LR, Cachay ER, (click to view)

Marks G, Patel U, Stirratt MJ, Mugavero MJ, Mathews WC, Giordano TP, Crepaz N, Gardner LI, Grossman C, Davila J, Sullivan M, Rose CE, O'Daniels C, Rodriguez A, Wawrzyniak AJ, Golden MR, Dhanireddy S, Ellison J, Drainoni ML, Metsch LR, Cachay ER,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Journal of acquired immune deficiency syndromes (1999) 2016 4 21()

Abstract
BACKGROUND
The HIV continuum of care paradigm uses a single viral load test per patient to estimate the prevalence of viral suppression. We compared this single-value approach with approaches that used multiple viral load tests to examine stability of suppression.

METHODS
The retrospective analysis included HIV patients who had at least two viral load tests during a 12-month observation period. We assessed (1) percent with suppressed viral load (<200 copies/ml) based on a single test during observation; (2) percent with suppressed viral loads on all tests during observation; (3) percent who maintained viral suppression among patients whose first observed viral load was suppressed; and (4) change in viral suppression status comparing first with last measurement occasions. Prevalence ratios compared demographic and clinical subgroups. RESULTS
Of 10,942 patients, 78.5% had a suppressed viral load based on a single test, whereas 65.9% were virally suppressed on all tests during observation. Of patients whose first observed viral load was suppressed, 87.5% were suppressed on all subsequent tests in next 12 months. More patients exhibited improving status (13.3% went from unsuppressed to suppressed) than worsening status (5.6% went from suppressed to unsuppressed). Stable suppression was less likely among women, younger patients, black patients, those recently diagnosed with HIV, and patients who missed ≥1 scheduled clinic visits.

CONCLUSIONS
Using single viral load measurements overestimated the percent of HIV patients with stable suppressed viral load by 16% (relative difference). Targeted clinical interventions are needed to increase the percent of patients with stable suppression.

Submit a Comment

Your email address will not be published. Required fields are marked *

18 − eight =

[ HIDE/SHOW ]