HIV Viral Load Suppression in Adults and Children Receiving Antiretroviral Therapy-Results From the IeDEA Collaboration
Althoff, Keri N.
Cortes, Claudia P.
Viet Chau Do
Machado, Daisy Maria [UNIFESP]
Is part ofJaids-Journal Of Acquired Immune Deficiency Syndromes
Australasian HIV and AIDS Conference
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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.
CitationJaids-Journal Of Acquired Immune Deficiency Syndromes. Philadelphia, v. 76, n. 3, p. 319-329, 2017.
SponsorshipU.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
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