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HIV treatment should rapidly achieve and maintain viral suppression

57% icon.

According to CDC data from 2021, approximately 1.2 million people aged 13 and older were living with HIV in the US at the end of 2019. An estimated 57% of those patients achieved viral suppression, which was measured as a viral load test result of <200 copies/mL at the most recent viral load test during the measurement year.1

A scientist holding a vial.

Optimal viral suppression

Optimal viral suppression is generally defined by the DHHS guidelines as a viral load consistently below a level of detection—typically HIV RNA <20 to 75 copies/mL depending on the assay used.2

It’s important to choose a treatment that not only rapidly achieves viral suppression, but also maintains viral suppression. After initiation of effective ART, viral load reduction to below limits of assay detection usually occurs within the first 12 to 24 weeks of therapy.2

Predictors of successful virologic suppression according to the DHHS guidelines2

  • Low baseline viremia
  • High potency of the ARV regimen
  • Tolerability of the regimen
  • Convenience of the regimen
  • Excellent adherence to the regimen

Incomplete viral suppression

Overlapping blue and green arrows.

higher inflammation and immune activation2

See how simple administration may impact adherence, and learn more about how adherence influences viral suppression.
What do the guidelines say about achieving durable viral suppression?

DHHS guidelines2

  • Durable viral suppression improves immune function and confers substantial clinical benefits, lowers the risk of both AIDS-defining and non-AIDS-defining complications, and allows people with HIV to have a life expectancy approaching that for people without HIV2
  • The Panel on Antiretroviral Guidelines for Adults and Adolescents recommends initiating ART immediately (or as soon as possible) after HIV diagnosis in order to increase the uptake of ART and linkage to care, decrease the time to viral suppression for individual patients, and improve the rate of virologic suppression among people with HIV2
  • To improve and maintain immunologic function and maintain viral suppression, ART should be continued indefinitely without interruption2
  • An easy-to-adhere-to, potent, safe, and tolerable regimen helps achieve sustained virologic suppression2

Rapidly achieving and maintaining viral suppression should be the primary goal of treatment with ART, which can help patients live longer, healthier lives.2

ART, antiretroviral therapy; ARV, antiretroviral; CDC, Centers for Disease Control and Prevention; DHHS, US Department of Health and Human Services.

References:

  1. HIV.gov. HIV care continuum. Published June 21, 2021. Accessed March 7, 2022. https://www.hiv.gov/federal-response/policies-issues/hiv-aids-care-continuum
  2. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated May 26, 2023. Accessed July 24, 2023. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/guidelines-adult-adolescent-arv.pdf