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dc.contributor.authorSusan H. Eshlemanen_US
dc.contributor.authorEthan A. Wilsonen_US
dc.contributor.authorXinyi C. Zhangen_US
dc.contributor.authorSan San Ouen_US
dc.contributor.authorEstelle Piwowar-Manningen_US
dc.contributor.authorJoseph J. Eronen_US
dc.contributor.authorMarybeth McCauleyen_US
dc.contributor.authorTheresa Gambleen_US
dc.contributor.authorJoel E. Gallanten_US
dc.contributor.authorMina C. Hosseinipouren_US
dc.contributor.authorNagalingeswaran Kumarasamyen_US
dc.contributor.authorJames G. Hakimen_US
dc.contributor.authorBen Kalongaen_US
dc.contributor.authorJose H. Pilottoen_US
dc.contributor.authorBeatriz Grinsztejnen_US
dc.contributor.authorSheela V. Godboleen_US
dc.contributor.authorNuntisa Chotirosniramiten_US
dc.contributor.authorBreno Riegel Santosen_US
dc.contributor.authorEmily Shavaen_US
dc.contributor.authorLisa A. Millsen_US
dc.contributor.authorRavindre Panchiaen_US
dc.contributor.authorNoluthando Mwelaseen_US
dc.contributor.authorKenneth H. Mayeren_US
dc.contributor.authorYing Q. Chenen_US
dc.contributor.authorMyron S. Cohenen_US
dc.contributor.authorJessica M. Fogelen_US
dc.description.abstract© 2017 Informa UK Limited, trading as Taylor & Francis Group. Introduction: The HIV Prevention Trials Network (HPTN) 052 trial demonstrated that early antiretroviral therapy (ART) prevented 93% of HIV transmission events in serodiscordant couples. Some linked infections were observed shortly after ART initiation or after virologic failure. Objective: To evaluate factors associated with time to viral suppression and virologic failure in participants who initiated ART in HPTN 052. Methods: 1566 participants who had a viral load (VL) > 400 copies/mL at enrollment were included in the analyses. This included 832 in the early ART arm (CD4 350–550 cells/mm3at ART initiation) and 734 in the delayed ART arm (204 with a CD4 < 250 cells/mm3at ART initiation; 530 with any CD4 at ART initiation). Viral suppression was defined as two consecutive VLs ≤ 400 copies/mL after ART initiation; virologic failure was defined as two consecutive VLs > 1000 copies/mL > 24 weeks after ART initiation. Results: Overall, 93% of participants achieved viral suppression by 12 months. The annual incidence of virologic failure was 3.6%. Virologic outcomes were similar in the two study arms. Longer time to viral suppression was associated with younger age, higher VL at ART initiation, and region (Africa vs. Asia). Virologic failure was strongly associated with younger age, lower educational level, and lack of suppression by three months; lower VL and higher CD4 at ART initiation were also associated with virologic failure. Conclusions: Several clinical and demographic factors were identified that were associated with longer time to viral suppression and virologic failure. Recognition of these factors may help optimize ART for HIV treatment and prevention.en_US
dc.titleVirologic outcomes in early antiretroviral treatment: HPTN 052en_US
article.title.sourcetitleHIV Clinical Trialsen_US
article.volume18en_US Johns Hopkins School of Medicineen_US Hutchinson Cancer Research Centeren_US University of North Carolina at Chapel Hillen_US Facilitation Departmenten_US Facilitation Departmenten_US CARE Centeren_US of North Carolina Project Malawien_US Medical Centre Indiaen_US Huggins School of Medicineen_US of Malawi College of Medicineen_US Geral de Rio de Janeiroen_US Oswaldo Cruzen_US AIDS Research Institute Indiaen_US Mai Universityen_US Nossa Senhora da Conceicaoen_US Harvard AIDS Institute Partnershipen_US Medical Research Instituteen_US of Witwatersranden_US Medical Schoolen_US
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