Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

16 January 2012

Viral load's effect on ARV therapy

via aidsmap, by Michael Carter

Suppressing viral load to below 50 copies/ml may not be enough to ensure the long-term success of antiretroviral therapy, according to a UK study published in the March edition of Clinical Infectious Diseases.

Using ultra-sensitive viral load assays, investigators at the Royal Free Hospital, London, found that patients with a viral load between 40-49 copies/ml were significantly more likely to experience a rebound in viral load above 50 copies/ml and 400 copies/ml when compared to individuals with viral load between 39 and 3 to 10 copies/ml and patients with a truly undetectable viral load.

The investigators recommend “treatment efficacy should be reviewed” for patients whose viral load is above the very lowest levels.

However, the authors of an editorial accompanying the study are less convinced about the significance of its findings.

The goal of modern HIV therapy is a viral load below 50 copies/ml. Studies have shown that a sustained increase above this level is associated with the virological failure of therapy and the emergence of drug-resistant strains of HIV.

Assays capable of accurately measuring viral load to 40 copies/ml have been developed. In approximately two-thirds of cases, the assays can also detect viral load to a threshold of 10 copies/ml.
Viral load at an ultra-low level – between 3 to 10 copies/ml – is often labelled “residual viraemia” and cannot be eradicated with treatment intensification.

Read the rest.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

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