Incomplete adherence to antiretroviral therapy is associated with higher levels of residual HIV-1 viremia

Jonathan Z. Li, Sebastien Gallien, Heather Ribaudo, Andrea Heisey, David Bangsberg, Daniel R. Kuritzkes

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objectives:To evaluate the relationship between incomplete antiretroviral therapy (ART) adherence and levels of residual HIV-1 viremia. Design: Medication adherence and residual viremia less than 50 copies/ml were quantified in participants of a cohort of homeless and marginally housed individuals with HIV/AIDS. Methods: Participants had at least 6 months of virologic suppression of less than 50 copies/ml and were in the adherence monitoring cohort with monthly unannounced pill counts. Residual viremia was measured by the single-copy assay. Results: The median average ART adherence over the prior 1 and 2 months were 94% [interquartile range (IQR) 79-100%] and 93% (IQR 82-98%), respectively. Average ART adherence over the past 2 months was significantly associated with levels of residual HIV viremia (Spearman r=-0.25, P = 0.04). One-third of participants with 100% ART adherence over the past 2 months had detectable residual viremia. On multivariate regression analysis, ART adherence over the past 2 months, but not duration of virologic suppression, CD4 + T-cell count or or ART regimen, was significantly associated with levels of residual HIV viremia. Detectable residual viremia was associated with virologic failure (50 copies/ml) on univariate Cox proportional hazard analysis (hazard ratio 2.08, P = 0.02). However, on multivariate analysis, only ART adherence was associated with risk of virologic failure. Conclusion: Incomplete ART adherence is associated with higher levels of residual HIV-1 viremia, but detectable residual viremia can be present despite 100% measured ART adherence.

Original languageEnglish (US)
Pages (from-to)181-186
Number of pages6
JournalAIDS
Volume28
Issue number2
DOIs
StatePublished - Jan 14 2014
Externally publishedYes

Fingerprint

Viremia
HIV-1
Therapeutics
HIV
Multivariate Analysis
Medication Adherence
CD4 Lymphocyte Count
Acquired Immunodeficiency Syndrome
Regression Analysis
T-Lymphocytes

Keywords

  • HIV reservoir
  • Medication adherence
  • Residual viremia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Incomplete adherence to antiretroviral therapy is associated with higher levels of residual HIV-1 viremia. / Li, Jonathan Z.; Gallien, Sebastien; Ribaudo, Heather; Heisey, Andrea; Bangsberg, David; Kuritzkes, Daniel R.

In: AIDS, Vol. 28, No. 2, 14.01.2014, p. 181-186.

Research output: Contribution to journalArticle

Li, Jonathan Z. ; Gallien, Sebastien ; Ribaudo, Heather ; Heisey, Andrea ; Bangsberg, David ; Kuritzkes, Daniel R. / Incomplete adherence to antiretroviral therapy is associated with higher levels of residual HIV-1 viremia. In: AIDS. 2014 ; Vol. 28, No. 2. pp. 181-186.
@article{090a7404d5e94fc494573346e84c7298,
title = "Incomplete adherence to antiretroviral therapy is associated with higher levels of residual HIV-1 viremia",
abstract = "Objectives:To evaluate the relationship between incomplete antiretroviral therapy (ART) adherence and levels of residual HIV-1 viremia. Design: Medication adherence and residual viremia less than 50 copies/ml were quantified in participants of a cohort of homeless and marginally housed individuals with HIV/AIDS. Methods: Participants had at least 6 months of virologic suppression of less than 50 copies/ml and were in the adherence monitoring cohort with monthly unannounced pill counts. Residual viremia was measured by the single-copy assay. Results: The median average ART adherence over the prior 1 and 2 months were 94{\%} [interquartile range (IQR) 79-100{\%}] and 93{\%} (IQR 82-98{\%}), respectively. Average ART adherence over the past 2 months was significantly associated with levels of residual HIV viremia (Spearman r=-0.25, P = 0.04). One-third of participants with 100{\%} ART adherence over the past 2 months had detectable residual viremia. On multivariate regression analysis, ART adherence over the past 2 months, but not duration of virologic suppression, CD4 + T-cell count or or ART regimen, was significantly associated with levels of residual HIV viremia. Detectable residual viremia was associated with virologic failure (50 copies/ml) on univariate Cox proportional hazard analysis (hazard ratio 2.08, P = 0.02). However, on multivariate analysis, only ART adherence was associated with risk of virologic failure. Conclusion: Incomplete ART adherence is associated with higher levels of residual HIV-1 viremia, but detectable residual viremia can be present despite 100{\%} measured ART adherence.",
keywords = "HIV reservoir, Medication adherence, Residual viremia",
author = "Li, {Jonathan Z.} and Sebastien Gallien and Heather Ribaudo and Andrea Heisey and David Bangsberg and Kuritzkes, {Daniel R.}",
year = "2014",
month = "1",
day = "14",
doi = "10.1097/QAD.0000000000000123",
language = "English (US)",
volume = "28",
pages = "181--186",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Incomplete adherence to antiretroviral therapy is associated with higher levels of residual HIV-1 viremia

AU - Li, Jonathan Z.

AU - Gallien, Sebastien

AU - Ribaudo, Heather

AU - Heisey, Andrea

AU - Bangsberg, David

AU - Kuritzkes, Daniel R.

PY - 2014/1/14

Y1 - 2014/1/14

N2 - Objectives:To evaluate the relationship between incomplete antiretroviral therapy (ART) adherence and levels of residual HIV-1 viremia. Design: Medication adherence and residual viremia less than 50 copies/ml were quantified in participants of a cohort of homeless and marginally housed individuals with HIV/AIDS. Methods: Participants had at least 6 months of virologic suppression of less than 50 copies/ml and were in the adherence monitoring cohort with monthly unannounced pill counts. Residual viremia was measured by the single-copy assay. Results: The median average ART adherence over the prior 1 and 2 months were 94% [interquartile range (IQR) 79-100%] and 93% (IQR 82-98%), respectively. Average ART adherence over the past 2 months was significantly associated with levels of residual HIV viremia (Spearman r=-0.25, P = 0.04). One-third of participants with 100% ART adherence over the past 2 months had detectable residual viremia. On multivariate regression analysis, ART adherence over the past 2 months, but not duration of virologic suppression, CD4 + T-cell count or or ART regimen, was significantly associated with levels of residual HIV viremia. Detectable residual viremia was associated with virologic failure (50 copies/ml) on univariate Cox proportional hazard analysis (hazard ratio 2.08, P = 0.02). However, on multivariate analysis, only ART adherence was associated with risk of virologic failure. Conclusion: Incomplete ART adherence is associated with higher levels of residual HIV-1 viremia, but detectable residual viremia can be present despite 100% measured ART adherence.

AB - Objectives:To evaluate the relationship between incomplete antiretroviral therapy (ART) adherence and levels of residual HIV-1 viremia. Design: Medication adherence and residual viremia less than 50 copies/ml were quantified in participants of a cohort of homeless and marginally housed individuals with HIV/AIDS. Methods: Participants had at least 6 months of virologic suppression of less than 50 copies/ml and were in the adherence monitoring cohort with monthly unannounced pill counts. Residual viremia was measured by the single-copy assay. Results: The median average ART adherence over the prior 1 and 2 months were 94% [interquartile range (IQR) 79-100%] and 93% (IQR 82-98%), respectively. Average ART adherence over the past 2 months was significantly associated with levels of residual HIV viremia (Spearman r=-0.25, P = 0.04). One-third of participants with 100% ART adherence over the past 2 months had detectable residual viremia. On multivariate regression analysis, ART adherence over the past 2 months, but not duration of virologic suppression, CD4 + T-cell count or or ART regimen, was significantly associated with levels of residual HIV viremia. Detectable residual viremia was associated with virologic failure (50 copies/ml) on univariate Cox proportional hazard analysis (hazard ratio 2.08, P = 0.02). However, on multivariate analysis, only ART adherence was associated with risk of virologic failure. Conclusion: Incomplete ART adherence is associated with higher levels of residual HIV-1 viremia, but detectable residual viremia can be present despite 100% measured ART adherence.

KW - HIV reservoir

KW - Medication adherence

KW - Residual viremia

UR - http://www.scopus.com/inward/record.url?scp=84892374299&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892374299&partnerID=8YFLogxK

U2 - 10.1097/QAD.0000000000000123

DO - 10.1097/QAD.0000000000000123

M3 - Article

C2 - 24361679

AN - SCOPUS:84892374299

VL - 28

SP - 181

EP - 186

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 2

ER -