Slow or fast viral load decay as a predictor of residual viremia level in HIV-infected patients undergoing successful first-line cART

Research output: Contribution to journalArticle

Abstract

Persistent residual viremia (RV) has been demonstrated in 70-90% of patients under successful cART. We analyzed the RV trend during the frst year following cART-induced VIROlogical suppression (VS; HIVRNA <50 copies/ml) to identify predictors of achievement and maintenance of ultra-deep RV suppression (URVS; HIV-RNA <5 copies/ml) in 60 naïve patients. These patients were aligned at the time of reaching VS and were longitudinally tested with an ultrasensitive HIV-RNA assay. The influence of demographics, primary/chronic infection, pre-therapy HIV-RNA and CD4, cART regimen and time to reach VS on RV trends was evaluated. During the first year following VS, median RV levels steadily decreased. RV dropped below 5 copies/ml at least once in each patient, but URVS was maintained in 45% of patients. RV rebounded to levels fluctuating around 5-10 copies/ml while in the remaining 55% of patients. Predictors of early achievement and maintenance of stable URVS were fast (<12 weeks) VS achievement after the start of therapy, better pre-treatment VIRO-immunological conditions (lower viremia and higher CD4 before cART), and treatment initiation during primary infection. These findings emphasize the importance of an early onset of potent antiretroviral regimens. RV trends should be further studied in detail in the following years of cART.

Original languageEnglish
Pages (from-to)234-241
Number of pages8
JournalNew Microbiologica
Volume40
Issue number4
Publication statusPublished - Oct 1 2017

Keywords

  • ART
  • HIV RNA
  • Residual viremia
  • Ultrasensitive assay
  • Viral load
  • Virological suppression

ASJC Scopus subject areas

  • Microbiology (medical)

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