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Episodes of HIV viremia and the risk of non-AIDS diseases in patients on suppressive antiretroviral therapy

Abstract:

Background: Several studies reported an association between immunodeficiency and non–AIDS-defining diseases. We investigated whether nonstructured treatment interruptions and episodes of viremia during suppressive combination antiretroviral therapy were independently associated with non-AIDS diseases. Methods: Six thousand four hundred forty patients with viral suppression (< 50 copies/mL) within 48 weeks of starting combination antiretroviral therapy were selected from the Dutch ATHENA cohort. In proportional hazards models, associations between treatment interruptions, viral suppression, low-level (50–400 copies/mL), and high-level viremia (> 400), and serious non-AIDS diseases (cardiovascular disease, chronic renal failure, liver fibrosis/cirrhosis) were investigated by including time-updated cumulative exposure to either viremia and interruptions or HIV RNA> 400 copies per milliliter. Results …