Skip to main content
profile image
Selected Works of David Bangsberg
Article
Duration of Viral Suppression and Risk of Rebound Viremia with First-Line Antiretroviral Therapy in Rural Uganda
AIDS and Behavior (2016)
  • Nicholas Musinguzi, Mbarara University of Science and Technology
  • Rain A. Mocello, University of California in San Francisco
  • Yap Boum, II, Epicentre Research Base
  • Peter W. Hunt, University of California in San Francisco
  • Jeffrey N. Martin, University of California in San Francisco
  • Jessica Haberer, Massachusetts General Hospital
  • David R. Bangberg, Portland State University
  • Mark J. Siedner, Center for Global Health, Massachusetts General Hospital
Find in your library
Abstract
Little is known about associations between viral suppression, adherence, and duration of prior viral suppression in sub-Saharan Africa. Study participants were from the UARTO study in Mbarara, Uganda. We fit regression models to characterize relationships between average adherence, treatment interruptions, and rebound viremia (>400 copies/mL) following a previously undetectable result. Our goal was to understand the impact of prior viral suppression on these relationships. 396 participants contributed 2864 quarterly visits. Restricted to periods with average adherence <50 %, each 10 % increase in adherence reduced the odds of rebound viremia by 74 % [adjusted odds ratio (AOR) = 0.26, P = 0.002] and 29 % (AOR = 0.71, P = 0.057) during the first 12 months of suppression and beyond 12 months respectively, interaction term P = 0.018. Among periods with adherence ≥50 %, the risk of rebound viremia decreased with increasing adherence during the first 12 months of viral suppression (AOR = 0.73 for each 10 % increase, P = 0.001), but not thereafter (AOR = 1.09, P = 0.67), interaction term P = 0.027. In contrast, 72-h interruptions, were associated with increased rebound viremia during the first 12 months (AOR = 1.30, P = 0.009) and after (AOR = 1.39, P = 0.005), interaction term P = 0.69. Completing 12 months of viral suppression decreases the impact of average adherence, but not prolonged treatment interruptions, on risk of rebound viremia.

At the time of writing, David Bangsberg was affiliated with Center for Global Health, Massachusetts General Hospital.
Keywords
  • Adherence,
  • Viremia,
  • Suppression,
  • Antiretroviral therapy
Disciplines
Publication Date
June, 2016
DOI
10.1007/s10461-016-1447-1
Publisher Statement
© Springer Science+Business Media New York 2016
Citation Information
Musinguzi N, Mocello RA, Boum Y, Hunt PW, Martin JN, Haberer JE, Bangsberg DR, Siedner MJ. Duration of Viral Suppression and Risk of Rebound Viremia with First-Line Antiretroviral Therapy in Rural Uganda. AIDS Behav. 2016 Jun 2.