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AIDS Patient Care STDS. 2013 Aug;27(8):459-66. doi: 10.1089/apc.2013.0105. Epub 2013 Jul 26.

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

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1
Baylor College of Medicine, Thomas Street Health Center, Houston, TX, USA.

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.

PMID:
23886048
PMCID:
PMC3739946
DOI:
10.1089/apc.2013.0105
[Indexed for MEDLINE]
Free PMC Article

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