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.

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