HIV Viral Load Suppression in Adults and Children Receiving Antiretroviral Therapy-Results From the IeDEA Collaboration

HIV Viral Load Suppression in Adults and Children Receiving Antiretroviral Therapy-Results From the IeDEA Collaboration

Author Jiamsakul, Awachana Google Scholar
Kariminia, Azar Google Scholar
Althoff, Keri N. Google Scholar
Cesar, Carina Google Scholar
Cortes, Claudia P. Google Scholar
Davies, Mary-Ann Google Scholar
Viet Chau Do Google Scholar
Eley, Brian Google Scholar
Gill, John Google Scholar
Kumarasamy, Nagalingeswaran Google Scholar
Machado, Daisy Maria Autor UNIFESP Google Scholar
Moore, Richard Google Scholar
Prozesky, Hans Google Scholar
Zaniewski, Elizabeth Google Scholar
Law, Matthew Google Scholar
Abstract Background: Having 90% of patients on antiretroviral therapy (ART) and achieving an undetectable viral load (VL) is 1 of the 90: 90: 90 by 2020 targets. In this global analysis, we investigated the proportions of adult and paediatric patients with VL suppression in the first 3 years after ART initiation. Methods: Patients from the IeDEA cohorts who initiated ART between 2010 and 2014 were included. Proportions with VL suppression (<1000 copies/ mL) were estimated using (1) strict intention to treat (ITT)-loss to follow-up (LTFU) and dead patients counted as having detectable VL; and (2) modified ITT-LTFU and dead patients were excluded. Logistic regression was used to identify predictors of viral suppression at 1 year after ART initiation using modified ITT. Results: A total of 35,561 adults from 38 sites/16 countries and 2601 children from 18 sites/6 countries were included. When comparing strict with modified ITT methods, the proportion achieving VL suppression at 3 years from ART initiation changed from 45.1% to 90.2% in adults, and 60.6% to 80.4% in children. In adults, older age, higher CD4 count preART, and homosexual/bisexual HIV exposure were associated with VL suppression. In children, older age and higher CD4 percentage pre-ART showed significant associations with VL suppression. Conclusions: Large increases in the proportion of VL suppression in adults were observed when we excluded those who were LTFU or had died. The increases were less pronounced in children. Greater emphasis should be made to minimize LTFU and maximize patient retention in HIV-infected patients of all age groups.
Keywords HIV
suppression
paediatrics
adults
IeDEA
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor U.S. National Institutes of Health's National Institute of Allergy and Infectious Diseases
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Cancer Institute
Centers for Disease Control and Prevention, USA
Agency for Healthcare Research and Quality, USA
Health Resources and Services Administration, USA
Canadian Institutes of Health Research, Canada
Ontario Ministry of Health and Long Term Care
Government of Alberta, Canada
Intramural Research Program of the National Cancer Institute
Australian Government Department of Health and Ageing
Grant number NCI: U01AI035004
NCI: U01AI035039
NCI: U01AI035040
NCI: U01AI035041
NCI: U01AI035042
NCI: U01AI037613
NCI: U01AI037984
NCI: U01AI038855
NCI: U01AI038858
NCI: U01AI042590
NCI: U01AI068634
NCI: U01AI068636
NCI: U01AI069432
NCI: U01AI069434
Centers for Disease Control and Prevention, USA: CDC-200-2006-18797
Centers for Disease Control and Prevention, USA: CDC-200-2015-63931
Agency for Healthcare Research and Quality, USA: 90047713
Health Resources and Services Administration, USA: 90051652
Canadian Institutes of Health Research, Canada: CBR-86906
Canadian Institutes of Health Research, Canada: CBR-94036
Canadian Institutes of Health Research, Canada: HCP-97105
Canadian Institutes of Health Research, Canada: TGF-96118
NCI: P30AI027757
NCI: P30AI027763
NCI: P30AI027767
NCI: P30AI036219
NCI: P30AI050410
NCI: P30AI094189
NCI: P30AI110527
NCI: P30MH62246
NCI: R01AA016893
NCI: R01CA165937
NCI: R01DA004334
NCI: R01DA011602
NCI: R01DA012568
NCI: R24AI067039
NCI: U01AA013566
NCI: U01AA020790
NCI: U01AI1031834
NCI: U01AI034989
NCI: U01AI034993
NCI: U01AI034994
NCI: M01RR000052
NCI: U54MD007587
NCI: UL1RR024131
NCI: UL1TR000004
NCI: UL1TR000083
NCI: UL1TR000454
NCI: UM1AI035043
NCI: Z01CP010214
NCI: Z01CP010176
NCI: U01AI069907
NCI: U01AI069923
NCI: U01AI069924
NCI: U01AI069918
NCI: F31DA037788
NCI: G12MD007583
NCI: K01A1093197
NCI: K23EY013707
NCI: K24DA000432
NCI: K24AI065298
NCI: KL2TR000421
NCI: N02CP055504
NCI: U01AI103390
NCI: U01AI103397
NCI: U01AI103401
NCI: U01AI103408
NCI: U01DA036935
NCI: U01HD032632
NCI: U10EY008057
NCI: U10EY008052
NCI: U10EY008067
NCI: U24AA020794
Date 2017
Published in Jaids-Journal Of Acquired Immune Deficiency Syndromes. Philadelphia, v. 76, n. 3, p. 319-329, 2017.
ISSN 1525-4135 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 319-329
Origin https://doi.org/10.1097/QAI.0000000000001499
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000416721800019
URI https://repositorio.unifesp.br/handle/11600/58250

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