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
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 (, 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
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
Anti-HIV Agents
Antiretroviral Therapy, Highly Active
Drug Administration Schedule
HIV Infections
Kaplan-Meier Estimate
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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