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Consequences of low-level viremia among women with HIV in the United States.
Aldredge, Amalia; Mehta, C Christina; Lahiri, Cecile D; Schneider, Michael F; Alcaide, Maria L; Anastos, Kathryn; Plankey, Michael; French, Audrey L; Floris-Moore, Michelle; Tien, Phyllis C; Dionne, Jodie; Dehovitz, Jack; Collins, Lauren F; Sheth, Anandi N.
Afiliação
  • Aldredge A; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.
  • Mehta CC; Grady Healthcare System, Ponce de Leon Center.
  • Lahiri CD; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.
  • Schneider MF; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.
  • Alcaide ML; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine.
  • Anastos K; Grady Healthcare System, Ponce de Leon Center.
  • Plankey M; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • French AL; Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, FL.
  • Floris-Moore M; Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
  • Tien PC; Division of General Internal Medicine, Department of Medicine, Georgetown University, DC.
  • Dionne J; Division of Infectious Diseases, Department of Medicine, Stroger Hospital of Cook County, Chicago, IL.
  • Dehovitz J; Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Collins LF; Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA.
  • Sheth AN; Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
AIDS ; 38(13): 1829-1838, 2024 Nov 01.
Article em En | MEDLINE | ID: mdl-39110550
ABSTRACT

OBJECTIVE:

Investigate the outcomes of women with HIV (WWH) with low-level viremia (LLV).

DESIGN:

The prevalence of LLV and potential clinical sequelae, such as virologic failure and non-AIDS comorbidity (NACM) development, are poorly characterized among WWH.

METHODS:

We analyzed data from the Women's Interagency HIV Study among WWH enrolled from 2003 to 2020 who reported antiretroviral therapy use at least 1 year followed by an HIV-1 viral load less than 200 copies/ml. Consecutive viral load measurements from four semi-annual visits were used to categorize women at baseline as having virologic suppression (all viral load undetectable), intermittent LLV (iLLV; nonconsecutive detectable viral load up to 199 copies/ml), persistent LLV (pLLV; at least two consecutive detectable viral load up to 199 copies/ml), or virologic failure (any viral load ≥200 copies/ml). Adjusted hazard ratios quantified the association of virologic category with time to incident virologic failure and multimorbidity (≥2 of 5 NACM) over 5-year follow-up.

RESULTS:

Of 1598 WWH, baseline median age was 47 years, 64% were Black, 21% Hispanic, and median CD4 + cell count was 621 cells/µl. After excluding 275 women (17%) who had virologic failure at baseline, 58, 19, and 6% were categorized as having virologic suppression, iLLV, and pLLV, respectively. Compared with WWH with virologic suppression, the adjusted hazard ratio [aHR; 95% confidence interval (CI)] for incident virologic failure was 1.88 (1.44-2.46) and 2.51 (1.66-3.79) for iLLV and pLLV, respectively; and the aHR for incident multimorbidity was 0.81 (0.54-1.21) and 1.54 (0.88-2.71) for iLLV and pLLV, respectively.

CONCLUSION:

Women with iLLV and pLLV had an increased risk of virologic failure. Women with pLLV had a trend towards increased multimorbidity risk.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Viremia / Infecções por HIV / Carga Viral Limite: Adult / Female / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Viremia / Infecções por HIV / Carga Viral Limite: Adult / Female / Humans / Middle aged País/Região como assunto: America do norte Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido