Population Viral Load, Viremia and Recent HIV-1 Infections: Findings from Population-based HIV Impact Assessments (PHIAs) in Zimbabwe, Malawi, and Zambia

Farahani, M.; Radin, E.; Saito, S.; Sachathep, K.; Hladik, W.A.; Voetsch, A.C.; Auld, A.; Balachandra, S.; Tippett Barr, B.; Low, A.; Smart, T. F.; Musuka, G.; Jonnalagadda, S.; Hakim, A.; Wadonda-Kabondo, N. W.; Jahn, A.; Mugurungi, O.; Williams, D.; Barradas, D. O.; Payne, D.; Parekh, B.; Patel, H.; wiesner, l.; Hoos, D.; Justman, J.

doi:10.1097/QAI.0000000000002637

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Population Viral Load, Viremia and Recent HIV-1 Infections: Findings from Population-based HIV Impact Assessments (PHIAs) in Zimbabwe, Malawi, and Zambia

8 01 2021
By Farahani, M. ; Radin, E. ; Saito, S. ; ...
http://dx.doi.org/10.1097/QAI.0000000000002637
Source: J Acquir Immune Defic Syndr. 87(Suppl 1):S81-S88

[PDF-438.53 KB]

English

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Details:

Alternative Title:

J Acquir Immune Defic Syndr
Personal Author:

Farahani, M. ; Radin, E. ; Saito, S. ; Sachathep, K. ; Hladik, W.A. ; ... More +

Farahani, M. ; Radin, E. ; Saito, S. ; Sachathep, K. ; Hladik, W.A. ; Voetsch, A.C. ; Auld, A. ; Balachandra, S. ; Tippett Barr, B. ; Low, A. ; Smart, T. F. ; Musuka, G. ; Jonnalagadda, S. ; Hakim, A. ; Wadonda-Kabondo, N. W. ; Jahn, A. ; Mugurungi, O. ; Williams, D. ; Barradas, D. O. ; Payne, D. ; Parekh, B. ; Patel, H. ; wiesner, l. ; Hoos, D. ; Justman, J. Less -
Description:

HIV population viral load (PVL) can reflect antiretroviral therapy program effectiveness and transmission potential in a community. Using nationally representative data from household surveys conducted in Zimbabwe, Malawi, and Zambia in 2015-16, we examined the association between various VL measures and the probability of at least one recent HIV-1 infection in the community.|We used limiting-antigen avidity enzyme immunoassay, viral load suppression (VLS) (HIV RNA <1000 copies/mL), and antiretrovirals in the blood to identify recent HIV-1 cases.|Among 1510 enumeration areas (EAs) across the 3 surveys, 52,036 adults aged 15-59 years resided in 1363 (90.3%) EAs with at least one HIV-positive adult consenting to interview and blood draw and whose VL was tested. Mean HIV prevalence across these EAs was 13.1% [95% confidence intervals (CI) 12.7 to 13.5]. Mean VLS prevalence across these EAs was 58.7% (95% CI: 57.3 to 60.0). In multivariable analysis, PVL was associated with a recent HIV-1 case in that EA (adjusted odds ratio: 1.4, 95% CI: 1.2 to 1.6, P = 0.001). VLS prevalence was inversely correlated with recent infections (adjusted odds ratio: 0.3, 95% CI: 0.1 to 0.6, P = 0.004). The 90-90-90 indicators, namely, the prevalence of HIV diagnosis, antiretroviral therapy coverage, and VLS at the EA level, were inversely correlated with HIV recency at the EA level.|We found a strong association between PVL and VLS prevalence and recent HIV-1 infection at the EA level across 3 southern African countries with generalized HIV epidemics. These results suggest that population-based measures of VLS in communities may serve as a proxy for epidemic control.
Subjects:

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Epidemiological Monitoring Health Surveys HIV-1 HIV Infections Humans Malawi Viral Load Viremia Zambia Zimbabwe
Keywords:

[+]

90-90-90 Indicators HIV HIV Incidence Population Viral Load Southern Africa
Source:

J Acquir Immune Defic Syndr. 87(Suppl 1):S81-S88
Pubmed ID:

33560041
Pubmed Central ID:

PMC10998157
Document Type:

Journal Article
Funding:

U2G GH001226/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/

U2G GH001226/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/ Less -
Volume:

87
Collection(s):

CDC Public Access
Main Document Checksum:

[+]

urn:sha256:e9806b55c2a39461ab4bed98db3d3312d8341a3a5f6f8b61bc5e32518a178d95
Download URL:

https://stacks.cdc.gov/view/cdc/154097/cdc_154097_DS1.pdf
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