Duration of Viral Suppression and Risk of Rebound Viremia with First-Line Antiretroviral Therapy in Rural Uganda

Nicholas Musinguzi, Rain A. Mocello, Yap Boum, Peter W. Hunt, Jeffrey N. Martin, Jessica E. Haberer, David R. Bangsberg, Mark J. Siedner

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1735-1740
Number of pages6
JournalAIDS and Behavior
Volume21
Issue number6
DOIs
StatePublished - Jun 1 2017

Keywords

  • ART
  • Adherence
  • Suppression
  • Viremia

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Musinguzi, N., Mocello, R. A., Boum, Y., Hunt, P. W., Martin, J. N., Haberer, J. E., Bangsberg, D. R., & Siedner, M. J. (2017). Duration of Viral Suppression and Risk of Rebound Viremia with First-Line Antiretroviral Therapy in Rural Uganda. AIDS and Behavior, 21(6), 1735-1740. https://doi.org/10.1007/s10461-016-1447-1