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Since HIV is more likely to be sexually transmitted when HIV viral loads are greater than 1500 copies/mL, Kate Buchacz presented data at CROI 2017, from 5,873 adult patients from the HOPS cohort, to assess the percentage of person-time spent with viral loads >1500 copies/mL, and how this changed over time. Of these, 86% were on ART, with a median 15 viral loads per patient. Overall, the number of patients with viral loads >1500 copies/mL decreased from 37% in 2000 to 10% in 2014, implying a decreasing risk for transmission. Over time, more patients used ART, including integrase inhibitors, and during the time when ART was prescribed, person-time spent with VL above 1500 copies/mL decreased from 32% in 2000 to 7% in 2014, demonstrating that adult US patients in routine HIV care spent substantially less time with VLs over 1500 copies/mL from 2000 to 2014. This time-period was also characterized by a shift toward universal ART initiation and continuous improvements in ART regimens. The observed trends imply a decreasing risk of HIV transmission from persons in HIV-care over the last decade and the need to focus interventions on subsets of patients more consistently viremic.

Kate Buchacz, Maria Mendoza, Carl Armon, Frank J. Palella, Charles Rose, Ellen Tedaldi, Richard Novak, Lytt Gardner. Time spent with HIV viral load >1500 copies/ml among patients in HIV care, 2000-2014. Presented February 14, 2017 at CROI 2017, Seattle, WA. Oral Abstract #30.

Source: Reporting from Seattle for PRN News: James Braun DO

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