What we talk about when we talk about durable viral suppression.
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ABSTRACT:
SUBMITTER: Diepstra K
PROVIDER: S-EPMC7845768 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
What we talk about when we talk about durable viral suppression.
Diepstra Karen K Lu Haidong H McManus Kathleen A KA Rogawski McQuade Elizabeth T ET Rhodes Anne G AG Westreich Daniel D
AIDS (London, England) 20200901 11
: As policies built on 'Undetectable = Untransmittable' become more popular, use of durable viral suppression (DVS) as an outcome in analyses is increasing. We identified a case series of recent HIV-related publications that study the DVS outcome. The majority did not distinguish between a definition of DVS and the operationalization of that definition. Clearer discussion of DVS, including a formal definition, is needed to ensure better comparability across studies and ultimately better public h ...[more]
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Project description:BackgroundTo assess long-term effectiveness of an intensive and comprehensive Ryan White Part A-funded HIV Care Coordination Program recruiting people living with HIV with a history of suboptimal HIV care outcomes.MethodsWe merged programmatic data on CCP clients with surveillance data on all adults diagnosed with HIV. Using propensity score matching, we identified a contemporaneous, non-CCP-exposed comparison group. Durable viral suppression (DVS) was defined as regular viral load (VL) monitoring and all VLs ≤200 copies per milliliter in months 13-36 of follow-up.ResultsNinety percent of the combined cohort (N = 12,414) had ≥1 VL ≤200 during the follow-up period (December 1, 2009-March 31, 2016), and nearly all had routine VL monitoring, but only 36.8% had DVS. Although DVS did not differ overall (relative risk: 0.99, 95% confidence interval: 0.95 to 1.03), CCP clients without any VL suppression (VLS) in the 12-month pre-enrollment showed higher DVS versus "usual care" recipients (21.3% versus 18.4%; relative risk: 1.16, 95% confidence interval: 1.04 to 1.29).ConclusionsEnrollment in an intensive intervention modestly improved DVS among those unsuppressed before CCP enrollment. This program shows promise for meeting treatment-as-prevention goals and advancing progress along the HIV care continuum, if people without evidence of VLS are prioritized for CCP enrollment over those with recent evidence of VLS. Low overall DVS (<40%) levels underscore a need for focused adherence maintenance interventions, in a context of high treatment access.
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Project description:This SuperSeries is composed of the SubSeries listed below.
2025-04-30 | GSE286996 | GEO
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