title: HIV Viral Load Monitoring Frequency and Risk of Treatment Failure among Immunologically Stable HIV-Infected Patients Prescribed Combination Antiretroviral Therapy.
abstract: The authors sought to assess whether viral load (VL) monitoring frequency was associated with differential rates of virologic failure (VF) among HIV Outpatient Study (HOPS) participants seen during 1999 to 2013, who had maintained VL <50 copies/mL, CD4 counts ≥300 cells/mm(3), and been prescribed a stable combination antiretroviral regimen for at least 2 years. The authors required VL and CD4 testing to have occurred regularly for the entire 2-year period. The authors assessed rates of VF comparing patients who maintained a frequent VL testing (≥3 VLs) to those who shifted to a less frequent schedule (2 VL) after the 2-year period. Virologic failure was observed among 116 of 573 participants. The authors did not detect statistically significant difference in frequency of VF among patients undergoing frequent (21.0%) versus less frequent VL testing (19.6%), even after multivariable adjustment. Biannual VL monitoring for stable patients with aviremia could generate substantial cost savings without the increased risk of VF.
authors: APEX Family Medicine, Denver, CO, USA International Association of Providers of AIDS Care, Washington, DC, USA byoung@iapac.org.
authors: Benjamin
authors: B
authors: Young
authors: Cerner Corporation, Kansas City, MO, USA.
authors: Rachel L D
authors: RL
authors: Hart
authors: Division of HIV/AIDS Prevention, Center for Disease Control and Prevention, Atlanta, GA, USA.
authors: Kate
authors: K
authors: Buchacz
authors: APEX Family Medicine, Denver, CO, USA.
authors: Mia
authors: M
authors: Scott
authors: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors: Frank
authors: F
authors: Palella
authors: John T
authors: JT
authors: Brooks
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D017211:Treatment Failure; D019562:Viral Load / Q000187:drug effects*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; diagnostics; viral load