Cumulative Exposure to HIV Replication Predicts Mortality

Having a higher number of “viremia copy-years” after starting antiretroviral therapy was associated with elevated mortality risk, regardless of CD4-cell count.

When researchers evaluate the prognostic importance of viral load, they generally assess a single viral-load measurement rather than values obtained longitudinally. However, baseline viral load is a poor predictor of outcomes following the initiation of potent antiretroviral therapy (ART), and cross-sectional measurements during treatment may not fully reflect viral burden.

Now, investigators report on the effect of something they call “viremia copy-years,” a marker of cumulative exposure to viral replication (akin to “pack-years” in tobacco research). Their analysis includes data from 2027 patients who started ART at any of eight U.S. sites between 2000 and 2008. Patients were followed for a median of 2.7 years after ART initiation and cont…

Reviewing Author

Paul E. Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

Paul E. Sax, MD

Disclosures

Consultant/Advisory BoardGilead Sciences; GlaxoSmithKline/ViiV; Merck; Shionogi

Grant/Research SupportNIH; Gilead Sciences; ViiV

Editorial BoardsUpToDate; Clinical Infectious Diseases

Cumulative Exposure to HIV Replication Predicts Mortality

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Reviewing Author