@article{0f9a07df44394a648d2b26cbf9529c27,
title = "Durable suppression of HIV-1 after virologic monitoring-based antiretroviral adherence counseling in rakai, Uganda",
abstract = "Objectives HIV viral load is recommended for monitoring antiretroviral treatment and identifying treatment failure. We assessed the durability of viral suppression after viral load-triggered adherence counseling among patients with HIV viremia 6 months after ART initiation. Design Observational cohort enrolled in an antiretroviral treatment program in rural Uganda. Methods Participants who underwent routine viral load determination every 24 weeks and had at least 48 weeks of follow-up were included in this analysis. Patients with viral loads >400 copies/ml at 24 weeks of treatment were given additional adherence counseling, and all patients were followed to assess the duration of viral suppression and development of virologic failure. Results 1,841 participants initiating antiretroviral therapy were enrolled in the Rakai Health Sciences Program between June 2005 and June 2011 and were followed with viral load monitoring every 24 weeks. 148 (8%) of patients did not achieve viral suppression at 24 weeks and were given additional adherence counseling. 85 (60%) of these patients had undetectable viral loads at 48 weeks, with a median duration of viral suppression of 240 weeks (IQR 193-288 weeks). Failure to achieve an undetectable viral load at 48 weeks was associated with age <30 years and 24 week viral load >2,000 copies/ml in multivariate logistic regression analysis. Conclusions The majority of patients with persistent viremia who were provided adherence counseling achieved robust viral suppression for a median 4.6 years. Access to virologic monitoring and adherence counseling is a priority in resource-limited settings.",
author = "Alexander Billioux and Gertrude Nakigozi and Kevin Newell and Chang, {Larry W.} and Quinn, {Thomas C.} and Gray, {Ron H.} and Anthony Ndyanabo and Ronald Galiwango and Valerian Kiggundu and David Serwadda and Reynolds, {Steven J.}",
note = "Funding Information: This project has been funded in whole or in part with federal funds from the National Cancer Institute under Contract No. HHSN261200800001E, the National Institute of Mental Health under contract K23MH086338, and by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. Leidos Biomedical Research, Inc., provided support in the form of a salary for author KN, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of this author are articulated in the ''author contributions'' section. The authors acknowledge the valuable contribution of the Rakai Health Sciences Program research participants and staff. Treatment for Rakai Program participants is supported through the US President''s Emergency Plan for AIDS Relief (PEPFAR). Publisher Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.",
year = "2015",
month = may,
doi = "10.1371/journal.pone.0127235",
language = "English (US)",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",
}