Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy
OBJECTIVE: A minority of HIV-1 positive individuals treated with antiretroviral therapy (ART) in primary HIV-1 infection (PHI) maintain viral suppression on stopping. Whether this is related to ART duration has not been explored. DESIGN: And Methods: Using SPARTAC trial data from individuals recruit...
| Main Authors: | , , , , , , , , , , , , |
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| 格式: | Journal article |
| 语言: | English |
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Public Library of Science
2013
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| _version_ | 1826289148052373504 |
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| author | Stöhr, W Fidler, S McClure, M Weber, J Cooper, D Ramjee, G Kaleebu, P Tambussi, G Schechter, M Babiker, A Phillips, R Porter, K Frater, J |
| author_facet | Stöhr, W Fidler, S McClure, M Weber, J Cooper, D Ramjee, G Kaleebu, P Tambussi, G Schechter, M Babiker, A Phillips, R Porter, K Frater, J |
| author_sort | Stöhr, W |
| collection | OXFORD |
| description | OBJECTIVE: A minority of HIV-1 positive individuals treated with antiretroviral therapy (ART) in primary HIV-1 infection (PHI) maintain viral suppression on stopping. Whether this is related to ART duration has not been explored. DESIGN: And Methods: Using SPARTAC trial data from individuals recruited within 6 months of seroconversion, we present an observational analysis investigating whether duration of ART was associated with post-treatment viraemic control. Kaplan-Meier estimates, logistic regression and Cox models were used. RESULTS: 165 participants reached plasma viral loads (VL) <400 copies/ml at the time of stopping therapy (ART stop). After ART stop, 159 experienced confirmed VL ≥400 copies/ml during median (IQR) follow-up of 167 (108,199) weeks. Most participants experienced VL rebound within 12 weeks from ART stop, however, there was a suggestion of a higher probability of remaining <400 copies/ml for those on ART >12 weeks compared to ≤12 weeks (p=0.061). Cumulative probabilities of remaining <400 copies/ml at 12, 52 and 104 weeks after ART stop were 21% (95%CI=13,30), 4% (1,9), and 4% (1,9) for ≤12 weeks ART, and 32% (22,42), 14% (7,22), and 5% (2,11) for >12 weeks. In multivariable regression, ART for >12 weeks was independently associated with a lower probability of being ≥400 copies/ml within 12 weeks of ART stop (OR=0.11 (95%CI=0.03,0.34), p<0.001)). In Cox models of time to VL ≥400 after 12 weeks, we only found an association with female sex (OR=0.2, p=0.001). CONCLUSION: Longer ART duration in PHI was associated with a higher probability of viral control after ART stop. TRIAL REGISTRATION: Controlled-Trials.com 76742797 http://www.controlled-trials.com/ISRCTN76742797. |
| first_indexed | 2024-03-07T02:24:29Z |
| format | Journal article |
| id | oxford-uuid:a51e50f8-00fa-4be0-b2fd-9631c43a0b67 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:24:29Z |
| publishDate | 2013 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:a51e50f8-00fa-4be0-b2fd-9631c43a0b672022-03-27T02:38:15ZDuration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a51e50f8-00fa-4be0-b2fd-9631c43a0b67EnglishSymplectic Elements at OxfordPublic Library of Science2013Stöhr, WFidler, SMcClure, MWeber, JCooper, DRamjee, GKaleebu, PTambussi, GSchechter, MBabiker, APhillips, RPorter, KFrater, JOBJECTIVE: A minority of HIV-1 positive individuals treated with antiretroviral therapy (ART) in primary HIV-1 infection (PHI) maintain viral suppression on stopping. Whether this is related to ART duration has not been explored. DESIGN: And Methods: Using SPARTAC trial data from individuals recruited within 6 months of seroconversion, we present an observational analysis investigating whether duration of ART was associated with post-treatment viraemic control. Kaplan-Meier estimates, logistic regression and Cox models were used. RESULTS: 165 participants reached plasma viral loads (VL) <400 copies/ml at the time of stopping therapy (ART stop). After ART stop, 159 experienced confirmed VL ≥400 copies/ml during median (IQR) follow-up of 167 (108,199) weeks. Most participants experienced VL rebound within 12 weeks from ART stop, however, there was a suggestion of a higher probability of remaining <400 copies/ml for those on ART >12 weeks compared to ≤12 weeks (p=0.061). Cumulative probabilities of remaining <400 copies/ml at 12, 52 and 104 weeks after ART stop were 21% (95%CI=13,30), 4% (1,9), and 4% (1,9) for ≤12 weeks ART, and 32% (22,42), 14% (7,22), and 5% (2,11) for >12 weeks. In multivariable regression, ART for >12 weeks was independently associated with a lower probability of being ≥400 copies/ml within 12 weeks of ART stop (OR=0.11 (95%CI=0.03,0.34), p<0.001)). In Cox models of time to VL ≥400 after 12 weeks, we only found an association with female sex (OR=0.2, p=0.001). CONCLUSION: Longer ART duration in PHI was associated with a higher probability of viral control after ART stop. TRIAL REGISTRATION: Controlled-Trials.com 76742797 http://www.controlled-trials.com/ISRCTN76742797. |
| spellingShingle | Stöhr, W Fidler, S McClure, M Weber, J Cooper, D Ramjee, G Kaleebu, P Tambussi, G Schechter, M Babiker, A Phillips, R Porter, K Frater, J Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title | Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title_full | Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title_fullStr | Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title_full_unstemmed | Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title_short | Duration of HIV-1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
| title_sort | duration of hiv 1 viral suppression on cessation of antiretroviral therapy in primary infection correlates with time on therapy |
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