TY - JOUR
T1 - The association of clinical follow-up intervals in HIV-Infected persons with viral suppression on subsequent viral suppression
AU - Buscher, April
AU - Mugavero, Michael
AU - Westfall, Andrew O.
AU - Keruly, Jeanne
AU - Moore, Richard
AU - Drainoni, Mari Lynn
AU - Sullivan, Meg
AU - Wilson, Tracey E.
AU - Rodriguez, Allan
AU - Metsch, Lisa
AU - Gardner, Lytt
AU - Marks, Gary
AU - Malitz, Faye
AU - Giordano, Thomas P.
PY - 2013/8/1
Y1 - 2013/8/1
N2 - The recommendation for the frequency for routine clinical monitoring of persons with well-controlled HIV infection is based on evidence that relies on observed rather than intended follow-up intervals. We sought to determine if the scheduled follow-up interval is associated with subsequent virologic failure. Participants in this 6-clinic retrospective cohort study had an index clinic visit in 2008 and HIV viral load (VL) ≤400 c/mL. Univariate and multivariate tests evaluated if scheduling the next follow-up appointment at 3, 4, or 6 months predicted VL >400 c/mL at 12 months (VF). Among 2171 participants, 66%, 26%, and 8% were scheduled next follow-up visits at 3, 4, and 6 months, respectively. With missing 12-month VL considered VF, 25%, 25%, and 24% of persons scheduled at 3, 4, and 6 months had VF, respectively (p=0.95). Excluding persons with missing 12-month VL, 7.1%, 5.7%, and 4.5% had VF, respectively (p=0.35). Multivariable models yielded nonsignificant odds of VF by scheduled follow-up interval both when missing 12-month VL were considered VF and when persons with missing 12-month VL were excluded. We conclude that clinicians are able to make safe decisions extending follow-up intervals in persons with viral suppression, at least in the short-term.
AB - The recommendation for the frequency for routine clinical monitoring of persons with well-controlled HIV infection is based on evidence that relies on observed rather than intended follow-up intervals. We sought to determine if the scheduled follow-up interval is associated with subsequent virologic failure. Participants in this 6-clinic retrospective cohort study had an index clinic visit in 2008 and HIV viral load (VL) ≤400 c/mL. Univariate and multivariate tests evaluated if scheduling the next follow-up appointment at 3, 4, or 6 months predicted VL >400 c/mL at 12 months (VF). Among 2171 participants, 66%, 26%, and 8% were scheduled next follow-up visits at 3, 4, and 6 months, respectively. With missing 12-month VL considered VF, 25%, 25%, and 24% of persons scheduled at 3, 4, and 6 months had VF, respectively (p=0.95). Excluding persons with missing 12-month VL, 7.1%, 5.7%, and 4.5% had VF, respectively (p=0.35). Multivariable models yielded nonsignificant odds of VF by scheduled follow-up interval both when missing 12-month VL were considered VF and when persons with missing 12-month VL were excluded. We conclude that clinicians are able to make safe decisions extending follow-up intervals in persons with viral suppression, at least in the short-term.
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U2 - 10.1089/apc.2013.0105
DO - 10.1089/apc.2013.0105
M3 - Article
C2 - 23886048
AN - SCOPUS:84883142838
SN - 1087-2914
VL - 27
SP - 459
EP - 466
JO - AIDS patient care and STDs
JF - AIDS patient care and STDs
IS - 8
ER -