A moving target: impacts of lowering viral load suppression cutpoints on progress towards HIV epidemic control goals

Joseph G Rosen; Steven J Reynolds; Ronald M Galiwango; Godfrey Kigozi; Thomas C Quinn; Oliver Ratmann; Anthony Ndyanabo; Lisa J Nelson; Gertrude Nakigozi; Margaret Nalugemwa; Katherine B Rucinski; Caitlin E Kennedy; Larry W Chang; Joseph Kagaayi; David Serwadda; M Kate Grabowski

doi:10.1097/QAD.0000000000003593

A moving target: impacts of lowering viral load suppression cutpoints on progress towards HIV epidemic control goals

AIDS. 2023 Jul 15;37(9):1486-1489. doi: 10.1097/QAD.0000000000003593. Epub 2023 May 3.

Authors

Joseph G Rosen¹, Steven J Reynolds^{2

3

4}, Ronald M Galiwango², Godfrey Kigozi², Thomas C Quinn^{2

3

4}, Oliver Ratmann⁵, Anthony Ndyanabo², Lisa J Nelson⁶, Gertrude Nakigozi², Margaret Nalugemwa², Katherine B Rucinski¹, Caitlin E Kennedy^{1

2}, Larry W Chang^{1

2

3}, Joseph Kagaayi², David Serwadda², M Kate Grabowski^{2

7

8}

Affiliations

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Rakai Health Sciences Program, Entebbe, Uganda.
³ Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore.
⁴ Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
⁵ Department of Mathematics, Imperial College, London, UK.
⁶ Centers for Disease Control and Prevention, Kampala, Uganda.
⁷ Division of Pathology, Johns Hopkins School of Medicine.
⁸ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

PMID: 37395255
PMCID: PMC10328551 (available on 2024-07-15)
DOI: 10.1097/QAD.0000000000003593

Abstract

Redefining viral load suppression (VLS) using lower cutpoints could impact progress towards the United Nations Programme on HIV/AIDS 95-95-95 targets. We assessed impacts of lowering the VLS cutpoint on achieving the 'third 95' in the Rakai Community Cohort Study. Population VLS would fall from 86% to 84% and 76%, respectively, after lowering VLS cutpoints from <1000 to <200 and <50 copies/ml. The fraction of viremic persons increased by 17% after lowering the VLS cutpoint from <1000 to <200 copies/ml.

Publication types

Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Cohort Studies
Goals
HIV Infections* / drug therapy
HIV Infections* / epidemiology
HIV Infections* / prevention & control
Humans
Uganda
Viral Load

Abstract

Publication types

MeSH terms

Grants and funding