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An audit of viral load in one clinical population to describe features of viraemic patients on antiretroviral therapy
Author(s) -
Madge S,
Smith CJ,
Lampe F,
Sabin CA,
Youle M,
Johnson MA,
Phillips AN
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00548.x
Subject(s) - medicine , viral load , antiretroviral therapy , concomitant , population , audit , pediatrics , disease , human immunodeficiency virus (hiv) , intensive care medicine , immunology , environmental health , management , economics
Objectives To assess the prevalence of an undetectable viral load (VL) (<50 HIV‐1 RNA copies/mL) in a clinical population and to identify those viraemic and at risk of failing antiretroviral therapy (ART). Methods An audit of a complete clinical population on 1 January 2005 via a clinical database and clinical note review. Results On 1 January 2005, 1910 patients were under care; 1229/1332 (92%) of those exposed to ART for >16 weeks had a VL of <50 copies/mL. We examined 49/56 case notes of viraemic patients to identify explanations for viraemia. Common reasons included previous initial mono‐ or dual therapy, adherence problems, more advanced HIV disease, concomitant medications, physical and mental health issues and being less well linked into the service. A review of these patients' current status on 1 April 2007 showed that six of the 49 had since died. However, of those still alive, 20 (47%) had a VL <500 copies/mL. Conclusions The proportion of patients on ART with detectable viraemia is low in current clinical practice. New drugs may help those who are failing because of resistance. However, there is a small minority of patients who, for various reasons, appear unable to maintain sufficient adherence to ART.