The effect of HAART on HIV RNA trajectory among treatment-naïve men and women: a segmental Bernoulli/lognormal random effects model with left censoring.
BACKGROUND
Highly active antiretroviral therapy (HAART) rapidly suppresses human immunodeficiency virus (HIV) viral replication and reduces circulating viral load, but the long-term effects of HAART on viral load remain unclear.


METHODS
We evaluated HIV viral load trajectories over 8 years following HAART initiation in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. The study included 157 HIV-infected men and 199 HIV-infected women who were antiretroviral naive and contributed 1311 and 1837 semiannual person-visits post-HAART, respectively. To account for within-subject correlation and the high proportion of left-censored viral loads, we used a segmental Bernoulli/lognormal random effects model.


RESULTS
Approximately 3 months (0.30 years for men and 0.22 years for women) after HAART initiation, HIV viral loads were optimally suppressed (ie, with very low HIV RNA) for 44% (95% confidence interval = 39%-49%) of men and 43% (38%-47%) of women, whereas the other 56% of men and 57% of women had on average 2.1 (1.5-2.6) and 3.0 (2.7-3.2) log10 copies/mL, respectively.


CONCLUSIONS
After 8 years on HAART, 75% of men and 80% of women had optimal suppression, whereas the rest of the men and women had suboptimal suppression with a median HIV RNA of 3.1 and 3.7 log10 copies/mL, respectively.
Chu
Haitao
H
Department of Biostatistics and the Lineberger Comprehensive Cancer Center, the University of North Carolina, Chapel Hill, NC 27599, USA. hchu@bios.unc.edu
Gange
Stephen J
SJ
Li
Xiuhong
X
Hoover
Donald R
DR
Liu
Chenglong
C
Chmiel
Joan S
JS
Jacobson
Lisa P
LP
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011446:Prospective Studies; D012367:RNA, Viral / Q000187:drug effects; D013995:Time; D019562:Viral Load / Q000187:drug effects*
D019380:Anti-HIV Agents; D012367:RNA, Viral
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