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Viral blips during suppressive antiretroviral treatment are associated with high baseline HIV-1 RNA levels

Artikel i vetenskaplig tidskrift
Författare Erik Sörstedt
Staffan Nilsson
A. Blaxhult
Magnus Gisslén
L. Flamholc
A. Sonnerborg
Aylin Yilmaz
Publicerad i BMC Infectious Diseases
Volym 16
Sidor article number 305
ISSN 1471-2334
Publiceringsår 2016
Publicerad vid Institutionen för matematiska vetenskaper, matematisk statistik
Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor article number 305
Språk en
Länkar dx.doi.org/10.1186/s12879-016-1628-...
https://gup.ub.gu.se/file/199267
Ämnesord Viral blip, Transient viremia, HIV-1, Antiretroviral therapy
Ämneskategorier Infektionsmedicin

Sammanfattning

Background: Many HIV-1-infected patients on suppressive antiretroviral therapy (ART) have transiently elevated HIV RNA levels. The clinical significance of these viral blips is uncertain. We have determined the incidence of blips and investigated important associations in the Swedish HIV-cohort. Methods: HIV-1-infected ART naive adults who commenced ART 2007-2013 were retrospectively included. Viral blips were defined as a transient viral load between 50 and 500 copies/mL Subjects not suppressed after six months on ART were excluded. Results: Viral blips were found in 76/735 included subjects (10.3 %) and in 90/4449 samples (2.0 %). Median blip viral load was 76 copies/mL (range 56-138). Median follow-up time was 170 weeks (range 97-240). Baseline viral load was higher in subjects with viral blips (median log(10) 4.85 copies/mL) compared with subjects without blips (median log(10) 4.55 copies/mL) (p < 0.01). There was a significant association between viral blips and risk for subsequent virological failure (p < 0.001). Conclusions: The Swedish national HIV-cohort has a low incidence of viral blips (10 %). Blips were associated with high baseline viral load and an increased risk of subsequent virological failure.

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