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Predictors for high viraemia among the treatment naïve population in the United Kingdom.

Predictors for high viraemia among the treatment naïve population in the United Kingdom. Alison Brown , Adamma Aghaizu, Gary Murphy, Valerie Delpech. Background:. Viral load established as key predictor for HIV transmission

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Predictors for high viraemia among the treatment naïve population in the United Kingdom.

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  1. Predictors for high viraemia among the treatment naïve population in the United Kingdom. Alison Brown, Adamma Aghaizu, Gary Murphy, Valerie Delpech

  2. Background: • Viral load established as key predictor for HIV transmission • More evidence needed for population effect of Treatment as Prevention to reduce transmission • Treatment based upon clinical guidelines • Quick win? Identify groups of untreated HIV diagnosed people with elevated viraemiato target for prevention

  3. Aims: From a prevention perspective: • Describe distribution of viral load among the treatment naïve HIV-diagnosed population • Identify predictors of high viraemia among the untreated population • Discuss implications for prevention

  4. The treatment cascade among HIV positive people in the UK:2010 * Numbers were adjusted by missing information and rounded to the nearest 100. § Viral load <50 copies/ml after HIV treatment initiation in the year of initiation.

  5. The treatment cascade among HIV positive people in the UK:2010 87% of HIV diagnosed people with CD4 <350 receive treatment * Numbers were adjusted by missing information and rounded to the nearest 100. § Viral load <50 copies/ml after HIV treatment initiation in the year of initiation.

  6. Methods: • Comprehensive, national HIV surveillance data • Treatment naïve adults (≥15 years) accessing HIV care in the UK in 2010 • Patients diagnosed during 2010 categorised as: recently infected, late diagnosed & other • Most recent viral load in 2010; high viraemia was defined as >40,000 copies. • Multivariate analysis was conducted to identify predictors for high viraemia.

  7. Results: • In 2010, 68,600 adults accessed HIV care. • 8500 (12%) were treatment naïve and had viraemia information available: Median viral load: Elevated viral load

  8. Number and proportion of treatment-naive HIV positive adults with a viral load >40,000 copies/mL, UK, 2010

  9. Number and proportion of treatment-naive HIV positive adults with a viral load >40,000 copies/mL, UK, 2010

  10. Predictors for high viraemia:

  11. Discussion • Predictors of high viraemia provide a useful tool to target secondary prevention. • Need for rapid partner notification among the recently infected at diagnosis • Rapid ARV critical for those diagnosed late for prevention as well as clinical purposes. • The higher viraemia at older ages and among men requires further exploration.

  12. Thank youParticularly to Dr Zheng Yin and Cuong Chau www.hpa.org.uk

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