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Author Topic: CROI2010: Predictors of Attaining <1 copies/mL- Cross-sectional Study  (Read 1569 times)

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Offline John2038

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Interesting to know that 60% had confirmed (2 consecutive) HIV-RNA values of <1 copies/mL.

Predictors of Attaining <1 Plasma HIV/RNA copies/mL in a Large Italian Cross-sectional Study

Background:  Predictors of attaining <1 HIV-RNA copies/mL in plasma by antiretroviral therapy (ARV) have not been identified in large studies, but may be very important in the long-term management of HIV-infected patients.

Methods:  Cross-sectional study of patients (pts) on ARV followed at our center, with both HIV-RNA <50 copies/mL at the last 2 viral loads (VL) tested by Versant bDNA before testing by Versant kPCR and HIV-RNA <50 copies/mL at the 2 subsequent VLs tested by Versant kPCR (limit of quantification 1 copies/mL), were included in this analysis. Logistic regression was used at multivariable analysis. Main outcome measure: HIV-RNA <1 copies/mL. The detectability ratio (DR) was calculated as the number of HIV-RNA values of >50 copies/mL divided by the number of HIV-RNA values measured since the start of ARV up to the first kPCR testing. “New-drugs”-based regimens were those containing enfuvirtide, darunavir/r, raltegravir, maraviroc, or etravirine.

Results:  Since March 2009, all patients at our center had VL tested by Versant kPCR. Seven hundred thirty-nine patients (77% males) fulfilled inclusion criteria; at first kPCR testing, patients had a median (Q1, Q3) age of 46.6 (range: 42.2 to 51.5) years, were on ARV since a 11.1 (5.3 to 13.9) years, on their last ARV regimen since 1.4 (0.6 to 2.9) years, had 545 (390 to 736) CD4/mcL, a CD4 nadir of 213 (107 to 297) cells/mcL, and a DR of 0.42 (0.2 to 0.65); 135 (18.3%) were in C3 CDC stage, 275 (37.21%) were on-therapy with a PI/r-based regimen, 139 (18.81%) with an unboosted-PI-based, 204 (27.6%) with a NNRTI-based, 46 (6.22%) with a NRTI-based, and 75 (10.15%) with a “new-drugs”-based regimen. Four hundred forty-six of 739 (60.3%) had confirmed (2 consecutive) HIV-RNA values of <1 copies/mL. Variables independently associated with <1 HIV-RNA copies/mL were: female vs male gender (OR = 2.017; 95%CI 1.296 to 3.184; P =0.002), the DR (0.804 per 0.2-unit increment; 0.703 to 0.919; P =0.002), and being on a NNRTI- vs a PI/r-based regimen (1.871; 1.273 to 2.845; P =0.007). Age, risk factor, duration of ARV and duration of the last ARV, nadir CD4 count, CDC stage, CD4 count at first kPCR testing, and being on-therapy with a NRTI-, an unboosted PI- or a “new-drugs”-based regimen (compared to a PI/r-based regimen), were not independently associated with the ability of attaining <1 HIV-RNA copies/mL.

Conclusions:  Treatment with NNRTI- vs a PI/r-based regimen, female gender and the DR independently predict the ability of attaining <1 HIV-RNA copies/mL.[/navy]

« Last Edit: February 23, 2010, 05:13:58 PM by John2038 »


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