Viral Suppression Patterns Among Persons in the United States With Diagnosed HIV Infection in 2014

Letters19 September 2017Viral Suppression Patterns Among Persons in the United States With Diagnosed HIV Infection in 2014Nicole Crepaz, PhD, Tian Tang, MS, Gary Marks, PhD, and H. Irene Hall, PhDNicole Crepaz, PhDFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and ICF International, Marietta, Georgia., Tian Tang, MSFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and ICF International, Marietta, Georgia., Gary Marks, PhDFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and ICF International, Marietta, Georgia., and H. Irene Hall, PhDFrom Centers for Disease Control and Prevention, Atlanta, Georgia, and ICF International, Marietta, Georgia.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0278 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The most common measure of HIV suppression in clinical and surveillance studies is whether a patient's most recent viral load was less than 200 copies/mL during the preceding 12 months. This single-value measure provides only a snapshot of suppression status and does not capture changes in viral load over time (1, 2). Persons who are suppressed according to their most recent viral load measurement may still transmit HIV if their suppression status changes.Objective: To determine the usefulness of a single measure of viral load for understanding long-term suppression and examine the extent of cumulative HIV burden for understanding ...References1. Marks G, Patel U, Stirratt MJ, Mugavero MJ, Mathews WC, Giordano TP, et al. Single viral load measurements overestimate stable viral suppression among HIV patients in care: clinical and public health implications. J Acquir Immune Defic Syndr. 2016;73:205-12. [PMID: 27105049] doi:10.1097/QAI.0000000000001036 CrossrefMedlineGoogle Scholar2. Crepaz N, Tang T, Marks G, Mugavero MJ, Espinoza L, Hall HI. Durable viral suppression and transmission risk potential among persons with diagnosed HIV infection: United States, 2012-2013. Clin Infect Dis. 2016;63:976-83. [PMID: 27358354] doi:10.1093/cid/ciw418 CrossrefMedlineGoogle Scholar3. Crepaz N, Tang T, Marks G, Hall HI. Viral load dynamics among persons with diagnosed HIV: United States, 2014 [Abstract]. Presented at Conference on Retroviruses and Opportunistic Infections, Seattle, Washington, 13–16 February 2017. Abstract no. 31. Google Scholar4. Mugavero MJ, Napravnik S, Cole SR, Eron JJ, Lau B, Crane HM, et al; Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) Cohort Study. Viremia copy-years predicts mortality among treatment-naive HIV-infected patients initiating antiretroviral therapy. Clin Infect Dis. 2011;53:927-35. [PMID: 21890751] doi:10.1093/cid/cir526 CrossrefMedlineGoogle Scholar5. Quinn TC, Wawer MJ, Sewankambo N, Serwadda D, Li C, Wabwire-Mangen F, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med. 2000;342:921-9. [PMID: 10738050] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Centers for Disease Control and Prevention, Atlanta, Georgia, and ICF International, Marietta, Georgia.Presented in part at the Conference on Retroviruses and Opportunistic Infections, Seattle, Washington, 13–16 February 2017.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0278.This article was published at Annals.org on 8 August 2017. 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