Last data update: Jan 13, 2025. (Total: 48570 publications since 2009)
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Population viral load, viremia and recent HIV-1 infections: Findings from population-based HIV impact assessments (PHIAs) in Zimbabwe, Malawi, and Zambia
Farahani M , Radin E , Saito S , Sachathep K , Hladik WA , Voetsch AC , Auld A , Balachandra S , Tippett Barr B , Low A , Smart TF , Musuka G , Jonnalagadda S , Hakim A , Wadonda-Kabondo NW , Jahn A , Mugurungi O , Williams D , Barradas DO , Payne D , Parekh B , Patel H , Wiesner L , Hoos D , Justman J . J Acquir Immune Defic Syndr 2021 87 S81-S88 BACKGROUND: HIV population viral load (PVL) can reflect antiretroviral therapy (ART) program effectiveness and transmission potential in a community. Using nationally representative data from household surveys conducted in Zimbabwe, Malawi, and Zambia in 2015-16, we examined the association between various VL measures and the probability of at least one recent HIV-1 infection in the community. METHODS: We used Limiting-antigen (LAg) Avidity enzyme immunoassay (EIA), VLS (HIV RNA <1000 copies/mL), and ARVs in the blood to identify recent HIV-1 cases. RESULTS: Among 1,510 EAs across the three surveys, 52,036 adults aged 15-59 years resided in 1,363 (90.3%) EAs with at least one HIV-positive adult consenting to interview and blood draw and whose VL was tested. Mean HIV prevalence across these EAs was 13.1% (95% confidence intervals [CI] 12.7-13.5). Mean VLS prevalence across these EAs was 58.7% (95% CI 57.3-60.0).In multivariable analysis, PVL was associated with a recent HIV-1 case in that EA (adjusted odds ratio [AOR]: 1.4, 95% CI 1.2-1.6, p=0.001). VLS prevalence was inversely correlated with recent infections (AOR: 0.3, 95% CI 0.1-0.6, p=0.004). The 90-90-90 indicators, namely, the prevalence of HIV diagnosis, ART coverage, and VLS at the EA level, were inversely correlated with HIV recency at the EA level. CONCLUSION: We found a strong association between PVL and VLS prevalence and recent HIV-1 infection at the EA level across three southern African countries with generalized HIV epidemics. These results suggest that population-based measures of VLS in communities may serve as a proxy for epidemic control. |
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