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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
Authors: Stoehr, W
Fidler, S
McClure, M
Weber, J
Cooper, D
Ramjee, G
Kaleebu, P
Tambussi, G
Schechter, M
Babiker, A
Phillips, RE
Porter, K
Frater, J
Item Type: Journal Article
Abstract: 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.
Issue Date: 25-Oct-2013
Date of Acceptance: 9-Sep-2013
URI: http://hdl.handle.net/10044/1/49831
DOI: https://dx.doi.org/10.1371/journal.pone.0078287
ISSN: 1932-6203
Publisher: Public Library of Science
Journal / Book Title: PLoS ONE
Volume: 8
Issue: 10
Copyright Statement: © 2013 Stöhr et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: Wellcome Trust
National Institute for Health Research
Funder's Grant Number: 069598/Z/02/Z
NF-SI-0507-10313
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
MULTIDISCIPLINARY SCIENCES
SEROCONVERSION
INTERRUPTION
COUNT
LOAD
Adult
Anti-HIV Agents
Antiretroviral Therapy, Highly Active
Drug Administration Schedule
Female
HIV Infections
HIV-1
Humans
Kaplan-Meier Estimate
Male
Proportional Hazards Models
RNA, Viral
Viral Load
Young Adult
MD Multidisciplinary
General Science & Technology
Publication Status: Published
Article Number: ARTN e78287
Appears in Collections:Department of Medicine
Faculty of Medicine



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