Factors associated with virological suppression among HIV-positive individuals on highly active antiretroviral therapy in a multi-site Canadian cohort

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Abstract
Objective The aim of the study was to evaluate time to virological suppression in a cohort of individuals who started highly active antiretroviral therapy (HAART), and to explore the factors associated with suppression. Methods Eligible participants were HIV‐positive individuals from a multi‐site Canadian cohort of antiretroviral‐naïve patients initiating HAART on or after 1 January 2000. Viral load and CD4 measurements within 6 months prior to HAART initiation were assessed. Univariate and multivariate analyses were conducted using piecewise survival exponential models where time scale was divided into intervals (10 copies/mL, hazard ratio (HR) 1.27, 95% confidence interval (CI) 1.18–1.38; 10 copies/mL, HR 1.49, 95% CI 1.32–1.68] than patients with baseline viral load ≥5 log10 copies/mL; however, this effect ceased after 18 months of follow‐up. Suppression was more likely with nonnucleoside reverse transcriptase inhibitors and ritonavir‐boosted HAART. Conclusion Identification of patients at risk for diminished likelihood of virological suppression will allow focusing of efforts and the utilization of resources to maximize the benefits of HAART.

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