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:10.1101/2023.01.19.23284804

A Moving Target: Impacts of Lowering Viral Load Suppression Cutpoints on Progress Towards HIV Epidemic Control Goals

medRxiv [Preprint]. 2023 Jan 20:2023.01.19.23284804. doi: 10.1101/2023.01.19.23284804.

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, MD, USA.
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, United Kingdom.
⁶ Centers for Disease Control and Prevention, Kampala, Uganda.
⁷ Division of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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 UNAIDS 95-95-95 targets. We assessed impacts of lowering the VLS cutpoint on achieving the 95-95-95 VLS target in the Rakai Community Cohort Study. Population VLS fell from 86% to 84% and 76%, respectively, after lowering VLS cutpoints from <1,000 to <200 and <50 copies/mL. The fraction of viremic persons increased by 17% after lowering the VLS cutpoint from <1,000 to <200 copies/mL.

Publication types

Preprint

Abstract

Publication types

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