Viral Rebound Rates Low for People Living with HIV

The current rate of viral rebound for people living with HIV who achieved long-term viral suppression on first-line antiretroviral (ART) regimens is extremely low, according to the findings of a new study.

The analysis included 16,101 individuals enrolled in the UK Collaborative HIV Cohort Study and had achieved viral suppression by 9 months while taking an ART regimen of 3 or more drugs. Researchers investigated factors associated with viral rebound, such as age, year of ART initiation, and time since initiating ART. 

A total of 4519 individuals had a first viral rebound over 58,038 person-years. Of patients who experienced a viral rebound, 3105 (69%) had a viral load over 200 copies per mL and 1414 (31%) had documented treatment interruption. Among the 3105 patients with an observed viral rebound, 1322 (29%) had a following viral load value of 50 copies per mL or less with no regimen change after rebound.

The researcher found that current age at follow-up, the year ART was initiated, HIV risk group, higher pre-ART CD4 count, and pre-ART viral load were factors associated with viral rebound.

“A substantial proportion of people on ART will not have viral rebound over their lifetime, which has implications for people with HIV and the planning of future drug development,” the researchers concluded.

—Melissa Weiss

Reference:

O’Connor J, Smith C, Lampe FC, et al. Durability of viral suppression with first-line antiretroviral therapy in patients with HIV in the UK: an observational cohort study [published online May 4, 2017]. Lancet HIV. http://dx.doi.org/10.1016/S2352-3018(17)30053-X.