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Magnitude of Virologic Blips Is Associated With a Higher Risk for Virologic Rebound in HIV-Infected Individuals: A Recurrent Events Analysis

Grennan, J. Troy ; Loutfy, Mona R. ; Su, DeSheng ; Harrigan, P. Richard ; Cooper, Curtis ; Klein, Marina ; Machouf, Nima ; Montaner, Julio S. G. ; Rourke, Sean ; Tsoukas, Christos ; Hogg, Bob ; Raboud, Janet

The Journal of infectious diseases, 2012-04, Vol.205 (8), p.1230-1238 [Periódico revisado por pares]

Oxford: Oxford University Press

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Título:
Magnitude of Virologic Blips Is Associated With a Higher Risk for Virologic Rebound in HIV-Infected Individuals: A Recurrent Events Analysis
Autor: Grennan, J. Troy ; Loutfy, Mona R. ; Su, DeSheng ; Harrigan, P. Richard ; Cooper, Curtis ; Klein, Marina ; Machouf, Nima ; Montaner, Julio S. G. ; Rourke, Sean ; Tsoukas, Christos ; Hogg, Bob ; Raboud, Janet
Assuntos: Adult ; AIDS ; Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - therapeutic use ; Antiretrovirals ; Binomials ; Biological and medical sciences ; Carts ; Cohort Studies ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV 1 ; HIV Infections - virology ; HIV-1 - genetics ; HIV-1 - metabolism ; HIV/AIDS ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Infectious diseases ; Logistic Models ; Major and Brief Reports ; Male ; Medical sciences ; Microbiology ; Multivariate Analysis ; RNA ; RNA, Viral - blood ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load ; Viremia ; Virology
É parte de: The Journal of infectious diseases, 2012-04, Vol.205 (8), p.1230-1238
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Presented in part: 19th Annual Canadian Association of HIV Research Conference, Saskatoon, Saskatchewan, Canada, May 2010. Abstract O008.
All additional research team members are listed in the “Acknowledgments” section.
Descrição: Background. The importance of human immunodeficiency virus (HIV) blip magnitude on virologic rebound has been raised in clinical guidelines relating to viral load assays. Methods. Antiretroviral-naive individuals initiating combination antiretroviral therapy (cART) after 1 January 2000 and achieving virologic suppression were studied. Negative binomial models were used to identify blip correlates. Recurrent event models were used to determine the association between blips and rebound by incorporating multiple periods of virologic suppression per individual. Results. 3550 participants (82% male; median age, 40 years) were included. In a multivariable negative binomial regression model, the Amplicor assay was associated with a lower blip rate than branched DNA (rate ratio, 0.69; P < .01), controlling for age, sex, region, baseline HIV-1 RNA and CD4 count, AIDS-defining illnesses, year of cART initiation, cART type, and HIV-1 RNA testing frequency. In a multivariable recurrent event model controlling for age, sex, intravenous drug use, cART start year, cART type, assay type, and HIV-1 RNA testing frequency, blips of 500—999 copies/mL were associated with virologic rebound (hazard ratio, 2.70; P = .002), whereas blips of 50—499 were not. Conclusions. HIV-1 RNA assay was an important determinant of blip rates and should be considered in clinical guidelines. Blips ≥500 copies/mL were associated with increased rebound risk.
Editor: Oxford: Oxford University Press
Idioma: Inglês

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Magnitude of Virologic Blips Is Associated With a Higher Risk for Virologic Rebound in HIV-Infected Individuals: A Recurrent Events Analysis

Grennan, J. Troy ; Loutfy, Mona R. ; Su, DeSheng ; Harrigan, P. Richard ; Cooper, Curtis ; Klein, Marina ; Machouf, Nima ; Montaner, Julio S. G. ; Rourke, Sean ; Tsoukas, Christos ; Hogg, Bob ; Raboud, Janet

Oxford: Oxford University Press

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