Abstract
Background: Less than optimal adherence with antiretroviral therapy occurs commonly among human immunodeficiency virus HIV)-infected youth. In this study, our object was to identify patterns in the prefailure measurement of viral load (VL) that can reliably predict virological failure (VF) in HIV perinatally infected youth on highly active antiretroviral therapy (HAART). Methods: We conducted a retrospective chart review of HIV-infected youth with low-level viremia (LLV), defined as an HIV VL between the lower limits of detection (20-75 copies/mL) and 1000 copies/mL. All patients were perinatally infected, under 22 years of age, observed for at least 24 months of consecutive follow-up between May 2008 and July 2014, and received their HIV care at the University of Miami Miller School of Medicine. Of the 349 subjects screened, 100 were eligible for analysis. Virological failure was defined as 3 or more consecutive VLs greater than 1000 copies/mL. Multiple logistic regression and receiver operator characteristic curves were used to identify patterns in VL that ultimately resulted in VF. Results: Fifteen of the 100 patients experienced VF. Higher log10 mean VL, positive slope of the VL (log10 copies/mL per day), and fewer clinic visits were associated with a higher probability of VF. Sensitivity and specificity were. 87 and. 95, respectively. Resistance was not found in 12 of 15 patients with VF. Conclusions: Patients with LLV that had fewer clinic visits and a trend toward increasing VLs had an increased risk of VF. Noncompliance seems to be a major component of VF. Physicians should emphasize the critical nature of medication adherence.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 303-309 |
| Number of pages | 7 |
| Journal | Journal of the Pediatric Infectious Diseases Society |
| Volume | 8 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 18 2019 |
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Keywords
- antiretroviral
- HIV
- medication adherence
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Infectious Diseases
Cite this
Predicting Viral Failure in Human Immunodeficiency Virus Perinatally Infected Youth with Persistent Low-Level Viremia on Highly Active Antiretroviral Therapy. / Pereira, Ruth; Ludwig, David A.; Mathew, Sunil; Flores, Claudia; Dominguez, Sady; Gonzalez, Ivan; Rivera-Hernandez, Delia; Scott, Gwendolyn B.; Mitchell, Charles D.
In: Journal of the Pediatric Infectious Diseases Society, Vol. 8, No. 4, 18.01.2019, p. 303-309.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predicting Viral Failure in Human Immunodeficiency Virus Perinatally Infected Youth with Persistent Low-Level Viremia on Highly Active Antiretroviral Therapy
AU - Pereira, Ruth
AU - Ludwig, David A.
AU - Mathew, Sunil
AU - Flores, Claudia
AU - Dominguez, Sady
AU - Gonzalez, Ivan
AU - Rivera-Hernandez, Delia
AU - Scott, Gwendolyn B.
AU - Mitchell, Charles D.
PY - 2019/1/18
Y1 - 2019/1/18
N2 - Background: Less than optimal adherence with antiretroviral therapy occurs commonly among human immunodeficiency virus HIV)-infected youth. In this study, our object was to identify patterns in the prefailure measurement of viral load (VL) that can reliably predict virological failure (VF) in HIV perinatally infected youth on highly active antiretroviral therapy (HAART). Methods: We conducted a retrospective chart review of HIV-infected youth with low-level viremia (LLV), defined as an HIV VL between the lower limits of detection (20-75 copies/mL) and 1000 copies/mL. All patients were perinatally infected, under 22 years of age, observed for at least 24 months of consecutive follow-up between May 2008 and July 2014, and received their HIV care at the University of Miami Miller School of Medicine. Of the 349 subjects screened, 100 were eligible for analysis. Virological failure was defined as 3 or more consecutive VLs greater than 1000 copies/mL. Multiple logistic regression and receiver operator characteristic curves were used to identify patterns in VL that ultimately resulted in VF. Results: Fifteen of the 100 patients experienced VF. Higher log10 mean VL, positive slope of the VL (log10 copies/mL per day), and fewer clinic visits were associated with a higher probability of VF. Sensitivity and specificity were. 87 and. 95, respectively. Resistance was not found in 12 of 15 patients with VF. Conclusions: Patients with LLV that had fewer clinic visits and a trend toward increasing VLs had an increased risk of VF. Noncompliance seems to be a major component of VF. Physicians should emphasize the critical nature of medication adherence.
AB - Background: Less than optimal adherence with antiretroviral therapy occurs commonly among human immunodeficiency virus HIV)-infected youth. In this study, our object was to identify patterns in the prefailure measurement of viral load (VL) that can reliably predict virological failure (VF) in HIV perinatally infected youth on highly active antiretroviral therapy (HAART). Methods: We conducted a retrospective chart review of HIV-infected youth with low-level viremia (LLV), defined as an HIV VL between the lower limits of detection (20-75 copies/mL) and 1000 copies/mL. All patients were perinatally infected, under 22 years of age, observed for at least 24 months of consecutive follow-up between May 2008 and July 2014, and received their HIV care at the University of Miami Miller School of Medicine. Of the 349 subjects screened, 100 were eligible for analysis. Virological failure was defined as 3 or more consecutive VLs greater than 1000 copies/mL. Multiple logistic regression and receiver operator characteristic curves were used to identify patterns in VL that ultimately resulted in VF. Results: Fifteen of the 100 patients experienced VF. Higher log10 mean VL, positive slope of the VL (log10 copies/mL per day), and fewer clinic visits were associated with a higher probability of VF. Sensitivity and specificity were. 87 and. 95, respectively. Resistance was not found in 12 of 15 patients with VF. Conclusions: Patients with LLV that had fewer clinic visits and a trend toward increasing VLs had an increased risk of VF. Noncompliance seems to be a major component of VF. Physicians should emphasize the critical nature of medication adherence.
KW - antiretroviral
KW - HIV
KW - medication adherence
UR - http://www.scopus.com/inward/record.url?scp=85072663902&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072663902&partnerID=8YFLogxK
U2 - 10.1093/jpids/piy041
DO - 10.1093/jpids/piy041
M3 - Article
C2 - 29788421
AN - SCOPUS:85072663902
VL - 8
SP - 303
EP - 309
JO - Journal of the Pediatric Infectious Diseases Society
JF - Journal of the Pediatric Infectious Diseases Society
SN - 2048-7207
IS - 4
ER -