Early HIV viral suppression associated with subsequent 12-month treatment success among people living with HIV in South Africa.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: England NLM ID: 100897392 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-1293 (Electronic) Linking ISSN: 14642662 NLM ISO Abbreviation: HIV Med Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford : Wiley
      Original Publication: Oxford : Blackwell Science, c1999-
    • Subject Terms:
    • Abstract:
      Background: We analyzed the STREAM (Simplifying HIV TREAtment and Monitoring) study to determine risk factors associated with HIV viraemia and poor retention 18 months after initiation of antiretroviral therapy (ART).
      Methods: The STREAM study was an open-label randomized controlled trial in Durban, South Africa, that enrolled 390 people living with HIV presenting for their first HIV viral load measurement ~6 months after ART initiation. We used modified Poisson regression with robust standard errors to describe associations between baseline characteristics and three HIV outcomes 18 months after ART initiation: HIV viraemia (>50 copies/mL), poor retention in HIV care, and a composite outcome of poor retention in care and/or HIV viraemia.
      Results: Approximately 18 months after ART initiation, 45 (11.5%) participants were no longer retained in care and 43 (11.8%) had viraemia. People with CD4 counts <200 and those with viraemia 6 months after ART initiation were significantly more likely to have viraemia 18 months after ART initiation (adjusted relative risk [aRR] 4.0; 95% confidence interval [CI] 2.1-7.5 and aRR 5.5; 95% CI 3.3-9.0, respectively). People who did not disclose their HIV status and had viraemia after ART initiation were more likely to not be retained in care 12 months later (aRR 2.6; 95% CI 1.1-6.1 and aRR 2.2; 95% CI 1.0-4.8). People with a CD4 count <200 and those with viraemia were more likely to not achieve the composite outcome 18 months after ART initiation.
      Conclusions: Viraemia after ART initiation was the strongest predictor of subsequent viraemia and poor care retention. Understanding early indicators can help target our interventions to better engage people who may be more likely to experience persistent viraemia or disengage from HIV care.
      (© 2024 British HIV Association.)
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    • Grant Information:
      Center for AIDS Research, University of Washington; National Institute of Allergy and Infectious Diseases; South African National Health Laboratory Service Research Trust
    • Contributed Indexing:
      Keywords: HIV; point‐of‐care; retention in care; viral failure; viral load monitoring
    • Accession Number:
      0 (Anti-HIV Agents)
    • Publication Date:
      Date Created: 20240315 Date Completed: 20240605 Latest Revision: 20240605
    • Publication Date:
      20240606
    • Accession Number:
      10.1111/hiv.13633
    • Accession Number:
      38488308