Abstract
BackgroundAn undetectable serum HIV-1 load is key to effectiveness of antiretroviral (ARV) therapy, which depends on adherence to treatment. We evaluated factors possibly associated with ARV adherence and virologic response in HIV-infected heterosexual individuals.MethodsA cross-sectional study was conducted in 200 HIV-1 serodiscordant couples and 100 unpartnered individuals receiving ARV treatment at a tertiary hospital in southern Brazil. All subjects provided written informed consent, answered demographic/behavioral questionnaires through audio computer-assisted self-interviews (ACASI), and collected blood and vaginal samples for biological markers and assessment of sexually transmitted infections (STIs). HIV-negative partners were counseled and tested for HIV-1.ResultsThe study population mean age was 39.9 years, 53.6% were female, 62.5% were Caucasian, 52.6% had incomplete or complete elementary education, 63.1% resided in Porto Alegre. Demographic, behavioral and biological marker characteristics were similar between couples and single individuals. There was an association between adherence reported on ACASI and an undetectable serum viral load (P<0.0001). Logistic regression analysis demonstrated that single-tablet ARV-regimens were independently associated with adherence (OR = 2.3; 95CI%: 1.2–4.4; P = 0.011) after controlling for age, gender, education, marital status, personal income, ARV regimen, and median time of ARV use. A positive correlation between genital secretion PCR results and serum viral load was significant in the presence of STIs (r = 0.359; P = 0.017). Although HIV PCR detection in vaginal secretions was more frequent in women with detectable viremia (9/51, 17.6%), it was also present in 7 of 157 women with undetectable serum viral loads (4.5%), p = 0.005.ConclusionsARV single tablet regimens are associated with adherence. Detectable HIV-1 may be present in the genital secretions of women with undetectable viremia which means there is potential for HIV transmission in adherent individuals with serologic suppression.
Highlights
According to the World Health Organization (WHO)[1], approximately 1.7 million adults have recently become infected with HIV-1 and more than 90 percent of these infections are sexually transmitted, occurring in individuals of reproductive age
There was an association between adherence reported on audio computer-assisted self-interviews (ACASI) and an undetectable serum viral load (P
ARV single tablet regimens are associated with adherence
Summary
According to the WHO[1], approximately 1.7 million adults have recently become infected with HIV-1 and more than 90 percent of these infections are sexually transmitted, occurring in individuals of reproductive age. Through the landmark study HIV Prevention Trial Network 052 (HPTN 052), the benefit of using ARV to prevent HIV-1 sexual transmission among serodiscordant heterosexual couples was clearly demonstrated[5]. Given the benefits demonstrated by HPTN 052, current research efforts focus on the effectiveness of antiretroviral treatment as a real-world prevention tool outside of the safety of a well-designed controlled clinical trial in an eligible patient population[7]. This is a important point, because despite the current advances in prevention strategies, the number of new cases of HIV-1 transmission continues to increase as demonstrated by country statistics[1]. We evaluated factors possibly associated with ARV adherence and virologic response in HIV-infected heterosexual individuals
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
