People who do not promptly achieve viral suppression after starting antiretroviral (ARV) treatment for HIV are at a significantly higher long-term risk of death, aidsmap reports.
Publishing their findings in the journal AIDS, researchers studied a population of U.S. residents with HIV who began ARVs between 1998 and 2014. They were followed for up to 10 years.
Upon their entry into the study, the participants had a median age of 40. Eighty-three percent of the participants were male; 62 percent were men who have sex with men; 45 percent were white; and 12 percent reported ever injecting drugs. Their median viral load before starting ARVs was 75,000, and their median year of starting treatment was 2007. About one in three participants had been diagnosed with AIDS before beginning HIV treatment.
The participants were followed for a median 6.2 years. A total of 863 of them died.
Fifty-seven percent of the participants had a viral load below 20, considered full viral suppression, six months after starting ARVs. Fifteen percent had a viral load of 1,000 or greater at this point.
The researchers found that compared with having a viral load below 20 six months after starting ARVs, having a viral load of 1,000 or higher was associated with a 1.96-fold increased risk of dying over 10 years. Having a viral load as low as 130 six months into treatment was associated with a 1.39-fold increased risk of death over a decade compared with having full viral suppression.
The average risk of death for those with full viral suppression after six months of ARVs was 13 percent, compared with 14 percent among those with a viral load between 20 and 400, 20 percent for those with a viral load between 400 and 999 and 23 percent for those with a viral load of 1,000 or higher.
To read the aidsmap article, click here.
To read the study abstract, click here.