Duration of Viral Suppression and Risk of Rebound Viremia with First-Line Antiretroviral Therapy in Rural Uganda
Journal
AIDS and BehaviorAbstract
Little is known about associations between viral suppression, adherence, and duration of prior viral suppression in sub-Saharan Africa. Study participants were from the UARTO study in Mbarara, Uganda. We fit regression models to characterize relationships between average adherence, treatment interruptions, and rebound viremia (>400 copies/mL) following a previously undetectable result. Our goal was to understand the impact of prior viral suppression on these relationships. 396 participants contributed 2864 quarterly visits. Restricted to periods with average adherence <50 %, each 10 % increase in adherence reduced the odds of rebound viremia by 74 % [adjusted odds ratio (AOR) = 0.26, P = 0.002] and 29 % (AOR = 0.71, P = 0.057) during the first 12 months of suppression and beyond 12 months respectively, interaction term P = 0.018. Among periods with adherence ≥50 %, the risk of rebound viremia decreased with increasing adherence during the first 12 months of viral suppression (AOR = 0.73 for each 10 % increase, P = 0.001), but not thereafter (AOR = 1.09, P = 0.67), interaction term P = 0.027. In contrast, 72-h interruptions, were associated with increased rebound viremia during the first 12 months (AOR = 1.30, P = 0.009) and after (AOR = 1.39, P = 0.005), interaction term P = 0.69. Completing 12 months of viral suppression decreases the impact of average adherence, but not prolonged treatment interruptions, on risk of rebound viremia.PubMed ID
27256394Language
enISSN
1573-3254ae974a485f413a2113503eed53cd6c53
10.1007/s10461-016-1447-1
Scopus Count
Collections
Related articles
- Duration of Antiretroviral Therapy Adherence Interruption Is Associated With Risk of Virologic Rebound as Determined by Real-Time Adherence Monitoring in Rural Uganda.
- Authors: Haberer JE, Musinguzi N, Boum Y 2nd, Siedner MJ, Mocello AR, Hunt PW, Martin JN, Bangsberg DR
- Issue date: 2015 Dec 1
- Risk of viral failure declines with duration of suppression on highly active antiretroviral therapy irrespective of adherence level.
- Authors: Lima VD, Bangsberg DR, Harrigan PR, Deeks SG, Yip B, Hogg RS, Montaner JS
- Issue date: 2010 Dec
- Younger Age Predicts Failure to Achieve Viral Suppression and Virologic Rebound Among HIV-1-Infected Persons in Serodiscordant Partnerships.
- Authors: Mujugira A, Celum C, Tappero JW, Ronald A, Mugo N, Baeten JM
- Issue date: 2016 Feb
- Examining adherence barriers among women with HIV to tailor outreach for long-acting injectable antiretroviral therapy.
- Authors: Benning L, Mantsios A, Kerrigan D, Coleman JS, Golub E, Blackstock O, Konkle-Parker D, Philbin M, Sheth A, Adimora AA, Cohen MH, Seidman D, Milam J, Kassaye SG, Taylor T, Murray M
- Issue date: 2020 Jul 25
- A simple self-reported adherence tool as a predictor of viral rebound in people with viral suppression on antiretroviral therapy.
- Authors: O'Connor JL, Gardner EM, Esser S, Mannheimer SB, Lifson AR, Telzak EE, Phillips AN, International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) Strategies for Management of Antiretroviral Therapy (SMART) Study Group.
- Issue date: 2016 Feb