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Durable Viral Suppression and Transmission Risk Potential among Persons with Diagnosed HIV Infection: United States, 2012–2013

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  • Alternative Title:
    Clin Infect Dis
  • Personal Author:
  • Description:
    Background

    To examine durable viral suppression, cumulative viral load (VL) burden, and transmission risk potential among HIV-diagnosed persons in care.

    Methods

    Using data from the National HIV Surveillance System from 17 jurisdictions with complete reporting of VL test results, we determined the percentage of persons in HIV care who achieved durable viral suppression (all VL results <200 copies/mL) and examined viremia copy-years and time spent above VL levels that increase the risk of HIV transmission during 2012–2013.

    Results

    Of 265,264 persons in HIV care in 2011, 238,641 had at least two VLs in 2012–2013. The median number of VLs per individual during the 2-year period was five. Approximately 62% had durable viral suppression. The remaining 38% had high VL burden (geometric mean of viremia copy-years: 7,261) and spent an average of 438 days, 316 days, and 215 days (60%, 43.2%, and 29.5% of the 2-year time) above 200, 1,500, and 10,000 copies/mL. Women, blacks/African Americans, Hispanics/Latinos, persons with HIV infection attributed to transmission other than male-to-male sexual contact, younger age groups, and persons with gaps in care had higher viral burden and transmission risk potential.

    Conclusions

    Two-thirds of persons in HIV care had durable viral suppression during a 2-year period. One-third had high VL burden and spent substantial time above VL levels with increased risk of onward transmission. More intervention efforts are needed to improve retention in care and medication adherence so that more persons in HIV care achieve durable viral suppression.

  • Subjects:
  • Source:
    Clin Infect Dis. 63(7):976-983.
  • Pubmed ID:
    27358354
  • Pubmed Central ID:
    PMC5021630
  • Document Type:
    Journal Article
  • Funding:
    CC999999/Intramural CDC HHS/United States
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