title: The association of clinical follow-up intervals in HIV-infected persons with viral suppression on subsequent viral suppression.
abstract: The recommendation for the frequency for routine clinical monitoring of persons with well-controlled HIV infection is based on evidence that relies on observed rather than intended follow-up intervals. We sought to determine if the scheduled follow-up interval is associated with subsequent virologic failure. Participants in this 6-clinic retrospective cohort study had an index clinic visit in 2008 and HIV viral load (VL) ≤400 c/mL. Univariate and multivariate tests evaluated if scheduling the next follow-up appointment at 3, 4, or 6 months predicted VL >400 c/mL at 12 months (VF). Among 2171 participants, 66%, 26%, and 8% were scheduled next follow-up visits at 3, 4, and 6 months, respectively. With missing 12-month VL considered VF, 25%, 25%, and 24% of persons scheduled at 3, 4, and 6 months had VF, respectively (p=0.95). Excluding persons with missing 12-month VL, 7.1%, 5.7%, and 4.5% had VF, respectively (p=0.35). Multivariable models yielded nonsignificant odds of VF by scheduled follow-up interval both when missing 12-month VL were considered VF and when persons with missing 12-month VL were excluded. We conclude that clinicians are able to make safe decisions extending follow-up intervals in persons with viral suppression, at least in the short-term.
authors.affiliation: Baylor College of Medicine, Thomas Street Health Center, Houston, TX, USA.
authors.forename: April
authors.initials: A
authors.lastname: Buscher
authors.forename: Michael
authors.initials: M
authors.lastname: Mugavero
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Westfall
authors.forename: Jeanne
authors.initials: J
authors.lastname: Keruly
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.forename: Mari-Lynn
authors.initials: ML
authors.lastname: Drainoni
authors.forename: Meg
authors.initials: M
authors.lastname: Sullivan
authors.forename: Tracey E
authors.initials: TE
authors.lastname: Wilson
authors.forename: Allan
authors.initials: A
authors.lastname: Rodriguez
authors.forename: Lisa
authors.initials: L
authors.lastname: Metsch
authors.forename: Lytt
authors.initials: L
authors.lastname: Gardner
authors.forename: Gary
authors.initials: G
authors.lastname: Marks
authors.forename: Faye
authors.initials: F
authors.lastname: Malitz
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Giordano
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001071:Appointments and Schedules; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009819:Office Visits / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents