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Duration of Viral Suppression Strongly Modifies the
Adherence-Viral Rebound Relationship
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Reported by Jules Levin
5th IAS Capetown July 19-22 2009
Viviane Lima1, D Bangsberg2, PR Harrigan1, M Rosenblum3, S Deeks3, B Yip1, RS Hogg1, JS Montaner1
1 British Columbia Centre for Excellence in HIV/AIDS; 2 Harvard Medical School;
3 University of California, San Francisco
(vlima@cfenet.ubc.ca)
"Viral rebound was less likely to occur among those with long duration of suppression This translates in an odds of viral rebound decrease of 8% per each month of continuous viral suppression across all adherence levels. Individuals with high levels of adherence (≥95%), the probability of failure was 0.12 (IQR:
0.08-0.45) after being suppressed for 12 months and 0.04 (IQR 0.03-0.07) after being suppressed for 72 months". Sustained & near perfect adherence increases probability of long-term viral suppression, this is particularly critical at the earliest stages after starting HAART. From Jules: High levels (95%) of adherence required during first year on HART to achieve best chances for long-term viral suppression.
Table 1. Baseline characteristics associated with viral rebound and multivariate analysis result of baseline and time-dependent factors associated with viral rebound.
Figure 1. Estimated probabilities of viral rebound according to the percentage of follow-up time with suppressed (<50 copies/mL) HIV-1 plasma viral load by adherence level (0%-<40%, 40%-<80%, 80%-<95%, >95%)
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