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Time spent with HIV-RNA ≤ 200 copies/ml in a cohort of people with HIV during the U=U era

Madeddu, G; De Vito, A; Cozzi-Lepri, A; Cingolani, A; Maggiolo, F; Perno, CF; Gagliardini, R; ... Girardi, E; + view all (2021) Time spent with HIV-RNA ≤ 200 copies/ml in a cohort of people with HIV during the U=U era. AIDS , 35 (7) pp. 1103-1112. 10.1097/QAD.0000000000002825. Green open access

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Abstract

Objective: Zero risk of linked HIV transmission in sero-discordant couples when the HIV-infected partner had viral load (VL) <200 copies/mL (‘U status’) was found in observational studies. We aimed at estimating the proportion of time in which ‘U status’ was maintained and identifying factors associated with the risk of losing it. / Design: Observational cohort study. / Methods: We included participants in the ICONA cohort who had reached an established ‘U status’ (VL≤200 copies/mL for >6 months) as of December 2010. The outcome was the number of person-days of follow up (PDFU) above a VL>200 copies/ml, relative to the total number of PDFU observed. A logistic regression model was used to identify factors independently associated with the risk of losing ‘U status’. / Results: 8,241 persons living with HIV were included in the analysis who contributed 12,670,888 PDFU. Of these, 1,648 (20%) were female, 768 (9%) were people who inject drugs (PWID), and 2,066 (25%) were foreing-born. The median of VL measurements was 9 (IQR: 4–15). Overall, only 3.1% of PDFU were observed when VL was >200 copies/mL. The proportion of PDFU with VL>200 cp/ml was higher than average in females (5.3%), unemployed (5.4%), PWID (4.7%), and in people with>3 previous virologic failures (6.3%). These variables were significant predictors of losing ‘U status’ in the multivariable logistic regression. / Conclusions: Our results reinforce the validity of the U=U message in real-world setting. However, we identified subsets of our study population at higher risk of losing the ‘U status’ for whom additional efforts are needed.

Type: Article
Title: Time spent with HIV-RNA ≤ 200 copies/ml in a cohort of people with HIV during the U=U era
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/QAD.0000000000002825
Publisher version: https://doi.org/10.1097/QAD.0000000000002825
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV, U=U message, transmission, combination antiretroviral therapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10120999
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