460. HAART-experienced women with detectable plasma viral load continue to have genital tract HIV-1 RNA shedding despite changing treatment regimens in a clinical care program
Session: Poster Abstract Session: HIV Primary Care
Friday, October 21, 2011
Room: Poster Hall B1
  • IDSA_2011.pdf (524.6 kB)
  • Background: We longitudinally assess plasma viral load (PVL) and genital tract viral load (GTVL) among HIV-infected women changing highly active antiretroviral therapy (HAART) because of detectable PVL on current HAART regimens.

    Methods: Paired plasma and GT HIV-1 RNA were measured prospectively over 3 years.  Longitudinal analyses examined rates of GT HIV-1 RNA shedding and the association with PVL.

    Results: Sixteen women contributed a total of 205 study visits of whom all had detectable PVL and 69% had detectable GT HIV-1 RNA at baseline.  Half of the women were changed to new HAART regimens with 3 or more active antiretroviral drugs.  The probability of having detectable plasma HIV-1 RNA ≥30 days after changing HAART regimens was 0.56 (95% CI: 0.37 to 0.74).  Fourteen women (88%) had detectable PVL on a follow-up visit at least 30 or 60 days after changing HAART regimens; and 12 women (75%) had detectable GTVL on a follow-up at least 30 or 60 days after changing HAART regimens.  When PVL was undetectable, shedding occurred in at least one of the three genital subcompartments at 13% of visits; when PVL was detectable, shedding occurred in at least one of three subcompartments at 50% of visits.

    Conclusion:  A significant proportion of extensively treatment-experienced women continue to have detectable virus in both the plasma and genital tract following a change in treatment regimens, highlighting the difficulty of viral suppression in this patient population.  Further longitudinal studies are needed to better understand the interaction between genital tract and plasma viral load following virological failure.

    Subject Category: H. HIV/AIDS and other retroviruses

    Kartik Venkatesh, PhD1, Allison DeLong, MS2, Rami Kantor, MD3, Stacey Chapman, RN, ASN4, Jessica Ingersoll5, Jacklyn Kurpewski, BS4, Maria Depasquale, MD6, Richard D'Aquila, MD7, Angela Caliendo, MD, PhD, FIDSA8 and Susan Cu-Uvin, MD9, (1)community health, Brown University, PROVIDENCE, RI, (2)Brown University, Statistical Sciences, Providence, RI, (3)Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, (4)Miriam Hospital, Providence, RI, (5)Emory University, Atlanta, GA, (6)Vanderbilt University, Nashville, TN, (7)Vanderbilt Univ. Sch. of Med., Nashville, TN, (8)Emory University Hospital, Atlanta, GA, (9)The Miriam Hospital, Brown University, Providence, RI


    K. Venkatesh, None

    A. DeLong, None

    R. Kantor, None

    S. Chapman, None

    J. Ingersoll, None

    J. Kurpewski, None

    M. Depasquale, None

    R. D'Aquila, None

    A. Caliendo, Roche Diagnostics: Scientific Advisor, Consulting fee
    Abbott Diagnostics: Scientific Advisor, Consulting fee
    GenProbe: Scientific Advisor, Consulting fee
    Quidel: Scientific Advisor, Consulting fee
    Idaho Technologies: Scientific Advisor, Consulting fee
    Biotrin: Consultant, Consulting fee
    Roche Molecular: Investigator, Research support
    Qiagen: Investigator, Research support

    S. Cu-Uvin, None

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