Short communication

Factors associated with a strictly undetectable viral load in HIV-1-infected patients

  1. G Martin-Blondel1,2,*,
  2. K Sauné2,3,
  3. V Vu Hai1,
  4. B Marchou1,4,
  5. P Delobel1,2,
  6. J Izopet2,3,
  7. L Cuzin1,
  8. P Massip1

Article first published online: 21 MAR 2012

DOI: 10.1111/j.1468-1293.2012.01012.x

Issue

HIV Medicine

HIV Medicine

Volume 13, Issue 9, pages 568–573, October 2012

Additional Information

How to Cite

Martin-Blondel, G., Sauné, K., Vu Hai, V., Marchou, B., Delobel, P., Izopet, J., Cuzin, L. and Massip, P. (2012), Factors associated with a strictly undetectable viral load in HIV-1-infected patients. HIV Medicine, 13: 568–573. doi: 10.1111/j.1468-1293.2012.01012.x

Author Information

  1. 1

    Infectious and Tropical Diseases Department, Toulouse University Hospital, University Toulouse III, Toulouse, France

  2. 2

    INSERM UMR1043, Toulouse, France

  3. 3

    Virology Department, Toulouse University Hospital, University Toulouse III, Toulouse, France

  4. 4

    INSERM, CRCT U1087, Toulouse, France

*Correspondence: Dr Guillaume Martin-Blondel, Department of Infectious and Tropical Diseases, Toulouse University Hospital, Place du Docteur Baylac TSA 40031, 31059 Toulouse cedex 9, France. Tel: +33 561 77 20 49; fax: +33 561 77 21 38; e-mail: martin-blondel.g@chu-toulouse.fr

Publication History

  1. Issue published online: 11 SEP 2012
  2. Article first published online: 21 MAR 2012
  3. Manuscript Accepted: 16 FEB 2012

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Keywords:

  • antiretroviral therapy;
  • HIV-1 RNA;
  • low-level viraemia;
  • residual viraemia;
  • viral reservoirs

Objectives

The aim of the study was to identify factors associated with a strictly undetectable viral load (VL) using a routine sensitive real-time polymerase chain reaction (RT-PCR) technology.

Methods

From a large prospective cohort, 1392 patients with a VL < 50 HIV-1 RNA copies/mL while receiving a three-drug suppressive regimen for at least 1 year were included in a cross-sectional analysis. Patients were classified into three groups and compared by univariate and multivariate analysis: 479 patients with a strictly undetectable VL (group 1; 34%), 617 patients with detectable VL below the threshold of 20 copies/mL (group 2; 44%), and 296 patients with a VL of 20–50 copies/mL (group 3; 12%).

Results

Comparing groups 1 and 2, VL zenith < 5 log10 copies/mL [odds ratio (OR) 1.51; 95% confidence interval (CI) 1.15–1.99; P = 0.003], current CD4 T-cell count < 500 cells/μL (OR 1.44; 95% CI 1.08–1.92; P = 0.01), and duration of viral suppression < 50 copies/mL longer than 2 years (OR 2.32; 95% CI 1.20–4.54; P = 0.01) were associated with undetectable VL. Comparing groups 1 and 3, VL zenith < 5 log10 copies/mL (OR 2.48; 95% CI 1.75–3.50; P < 0.001), duration of viral suppression < 50 copies/mL longer than 1 year (OR 3.33; 95% CI 1.66–6.66; P = 0.0006), and nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (OR 1.45; 95% CI 1.03–2.04; P = 0.03) were associated with undetectable VL. No individual drug effect was found within NNRTI molecules.

Conclusions

Longer duration of viral suppression < 50 copies/mL, lower viral load zenith and NNRTI-based regimen were independently associated with a strictly undetectable viral load. This routinely used RT-PCR assay may prove to be a valuable tool in further large-scale studies.

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