Methods: A retrospective cohort study was completed comparing time to virologic failure in patients with LLV versus those with an undetectable VL while on antiretroviral therapy (ART) during the period of October 1, 2004 to September 30, 2014. A Kaplan-Meier analysis of event-free survival was used to compare the primary outcome between the study groups.
Results: There were 217 patients enrolled in the LLV group and 142 patients enrolled in the undetectable VL group. There were 138 patients in the LLV group and 42 patients in the undetectable VL group who progressed to virologic failure. The time to virologic failure was significantly greater in the LLV group compared to the undetectable VL group (9.3 months vs. 59.1 months, p<0.001). There was a significant increased risk of virologic failure in patients with previous documented virologic failure, patients receiving a boosted-protease inhibitor regimen, and patients receiving a regimen consisting of three NRTI medications.
Conclusion: Patients experiencing LLV are at an increased risk of virologic failure. There should be a heightened awareness among providers when their patients are having persistent VLs in order to make an early intervention and improve patient outcomes. Further investigation is needed to determine the effects of adherence on LLV as well as the most appropriate intervention.
L. Fletcher, None
M. Berg, None