The association of clinical follow-up intervals in HIV-Infected persons with viral suppression on subsequent viral suppression

April Buscher, Michael Mugavero, Andrew O. Westfall, Jeanne Keruly, Richard Moore, Mari Lynn Drainoni, Meg Sullivan, Tracey E. Wilson, Allan Rodriguez, Lisa Metsch, Lytt Gardner, Gary Marks, Faye Malitz, Thomas P. Giordano

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)459-466
Number of pages8
JournalAIDS patient care and STDs
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2013

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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