부산대학교 도서관

Objectives The aim of the study was to identify factors associated with a strictly undetectable viral load ( VL) using a routine sensitive real-time polymerase chain reaction ( RT-PCR) technology. Methods From a large prospective cohort, 1392 patients with a VL < 50 HIV-1 RNA copies/ mL while receiving a three-drug suppressive regimen for at least 1 year were included in a cross-sectional analysis. Patients were classified into three groups and compared by univariate and multivariate analysis: 479 patients with a strictly undetectable VL (group 1; 34%), 617 patients with detectable VL below the threshold of 20 copies/ mL (group 2; 44%), and 296 patients with a VL of 20-50 copies/ mL (group 3; 12%). Results Comparing groups 1 and 2, VL zenith < 5 log10 copies/ mL [odds ratio ( OR) 1.51; 95% confidence interval ( CI) 1.15-1.99; P = 0.003], current CD4 T-cell count < 500 cells/μ L ( OR 1.44; 95% CI 1.08-1.92; P = 0.01), and duration of viral suppression < 50 copies/ mL longer than 2 years ( OR 2.32; 95% CI 1.20-4.54; P = 0.01) were associated with undetectable VL. Comparing groups 1 and 3, VL zenith < 5 log10 copies/ mL ( OR 2.48; 95% CI 1.75-3.50; P < 0.001), duration of viral suppression < 50 copies/ mL longer than 1 year ( OR 3.33; 95% CI 1.66-6.66; P = 0.0006), and nonnucleoside reverse transcriptase inhibitor ( NNRTI)-based regimens ( OR 1.45; 95% CI 1.03-2.04; P = 0.03) were associated with undetectable VL. No individual drug effect was found within NNRTI molecules. Conclusions Longer duration of viral suppression < 50 copies/ mL, lower viral load zenith and NNRTI-based regimen were independently associated with a strictly undetectable viral load. This routinely used RT-PCR assay may prove to be a valuable tool in further large-scale studies. [ABSTRACT FROM AUTHOR]