The association of clinical follow-up intervals in HIV-infected persons with viral suppression on subsequent viral suppression.

Academic Article

Abstract

  • The recommendation for the frequency for routine clinical monitoring of persons with well-controlled HIV infection is based on evidence that relies on observed rather than intended follow-up intervals. We sought to determine if the scheduled follow-up interval is associated with subsequent virologic failure. Participants in this 6-clinic retrospective cohort study had an index clinic visit in 2008 and HIV viral load (VL) ≤400 c/mL. Univariate and multivariate tests evaluated if scheduling the next follow-up appointment at 3, 4, or 6 months predicted VL >400 c/mL at 12 months (VF). Among 2171 participants, 66%, 26%, and 8% were scheduled next follow-up visits at 3, 4, and 6 months, respectively. With missing 12-month VL considered VF, 25%, 25%, and 24% of persons scheduled at 3, 4, and 6 months had VF, respectively (p=0.95). Excluding persons with missing 12-month VL, 7.1%, 5.7%, and 4.5% had VF, respectively (p=0.35). Multivariable models yielded nonsignificant odds of VF by scheduled follow-up interval both when missing 12-month VL were considered VF and when persons with missing 12-month VL were excluded. We conclude that clinicians are able to make safe decisions extending follow-up intervals in persons with viral suppression, at least in the short-term.
  • Published In

  • AIDS patient care  Journal
  • Keywords

  • Adult, Anti-HIV Agents, Appointments and Schedules, Female, Follow-Up Studies, HIV Infections, Humans, Male, Multivariate Analysis, Office Visits, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Viral Load, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Buscher A; Mugavero M; Westfall AO; Keruly J; Moore R; Drainoni M-L; Sullivan M; Wilson TE; Rodriguez A; Metsch L
  • Start Page

  • 459
  • End Page

  • 466
  • Volume

  • 27
  • Issue

  • 8