Journal
EPIDEMIOLOGY
Volume 21, Issue -, Pages S25-S34Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EDE.0b013e3181ce9950
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Funding
- U.S. National Cancer Institute [CA16086]
- U.S. National Institutes of Health [P30-AI-50410]
- American Chemistry Council
- National Institute of Allergy and Infectious Diseases
- National Cancer Institute
- National Heart, Lung, and Blood Institute [UO1-AI-35042, 5-M01-RR-00052 (GCRC), UO1-AI-35043, UO1-AI-37984, UO1-AI-35039, UO1-AI-35040, UO1-AI-37613, UO1-AI-35041, U01-AI-35004, U01-AI-31834, U01-AI-34994, U01-AI-34989, U01-HD-32632, U01-AI-34993, U01-AI-42590, M01-RR00079, M01-RR00083]
- National Institute of Child Health & Human Development
- National Institute on Drug Abuse
- National Institute of Craniofacial and Dental Research
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Background: Highly active antiretroviral therapy (HAART) rapidly suppresses human immunodeficiency virus (HIV) viral replication and reduces circulating viral load, but the long-term effects of HAART on viral load remain unclear. Methods: We evaluated HIV viral load trajectories over 8 years following HAART initiation in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study. The study included 157 HIV-infected men and 199 HIV-infected women who were antiretroviral naive and contributed 1311 and 1837 semiannual person-visits post-HAART, respectively. To account for within-subject correlation and the high proportion of left-censored viral loads, we used a segmental Bernoulli/lognormal random effects model. Results: Approximately 3 months (0.30 years for men and 0.22 years for women) after HAART initiation, HIV viral loads were optimally suppressed (ie, with very low HIV RNA) for 44% (95% confidence interval = 39%-49%) of men and 43% (38%-47%) of women, whereas the other 56% of men and 57% of women had on average 2.1 (1.5-2.6) and 3.0 (2.7-3.2) log10 copies/mL, respectively. Conclusion: After 8 years on HAART, 75% of men and 80% of women had optimal suppression, whereas the rest of the men and women had suboptimal suppression with a median HIV RNA of 3.1 and 3.7 log10 copies/mL, respectively.
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