Increased duration of viral suppression is associated with lower viral rebound rates in patients with previous treatment failures

Objective: We investigated whether the rate of viral rebound decreases with increasing duration of viral suppression and, if so, whether rebound rates in patients previously failing antiretroviral regimens ultimately decline to levels as low as those seen in patients who have never experienced virological failure. Methods: All patients from the UK CHIC Study (n = 21256) who achieved a viral load (VL) of <50copies/ml while receiving HAART were followed until viral rebound (two consecutive VL > 400copies/ml). Patients could re-enter the analysis if they experienced a subsequent VL <50 copies/ml. Rebound rates were calculated according to the number of regimens previously failed and duration of viral suppression. Results: Of 12 648 patients on HAART 10237 (80.9%) achieved a VL 4 years were similar to those in patients who had at no time experienced treatment failure. Conclusion: After around 4 years of viral suppression rebound rates in individuals with multiple prior treatment failures approach those of individuals with no prior treatment failure. (c) 2007 Lippincott Williams & Wilkins