Virological Breakthrough: A Risk Factor for Loss to Followup in a Large Community-Based Cohort on Antiretroviral Therapy
2011

Virological Breakthrough and Loss to Follow-Up in HIV Treatment

Sample size: 2959 publication 10 minutes Evidence: moderate

Author Information

Author(s): Catherine Orrell, Richard Kaplan, Robin Wood, Linda-Gail Bekker

Primary Institution: Desmond Tutu HIV Centre, University of Cape Town

Hypothesis

Does experiencing virological breakthrough after initial suppression affect long-term outcomes in individuals on antiretroviral therapy?

Conclusion

Individuals who experience virological breakthrough are less likely to remain in care compared to those who maintain virological suppression.

Supporting Evidence

  • 4047 ART-naïve adults commenced ART, with 2959 achieving virological suppression.
  • 71% of those who achieved suppression remained suppressed, while 29% experienced breakthrough.
  • Of those with breakthrough, 67% resuppressed after an adherence intervention.

Takeaway

If someone with HIV has a spike in their viral load after being treated, they might have a harder time sticking with their treatment plan compared to those who stay healthy.

Methodology

The study reviewed ART-naïve adults who started treatment between 2002 and 2009, categorizing them based on their viral load outcomes.

Potential Biases

Potential bias in self-reported adherence and loss to follow-up data.

Limitations

The study relies on retrospective data and may not capture all factors influencing loss to follow-up.

Participant Demographics

The cohort included ART-naïve adults, with a majority being female and a median age of 35 years.

Statistical Information

P-Value

p<0.001

Confidence Interval

IQR 0.75–2.46 years

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1155/2011/469127

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