Changing how the third 95 is counted: suitable indicators for measuring U = U with findings from Taiwan

Area of Science:

• Infectious Diseases
• Public Health
• Virology

Background:

• The World Health Organization (WHO) aims for 95-95-95 HIV treatment goals by 2030.
• Accurate measurement of viral suppression quality is crucial for effective HIV care.
• Current metrics for viral suppression vary, complicating quality assessment.

Purpose of the Study:

• To examine long-term viral load suppression in HIV patients.
• To identify factors influencing sustained viral load control.
• To evaluate different viral load suppression indicators.

Main Methods:

• Analysis of viral load testing data from living HIV patients up to 2019-2020.
• Calculation of durable viral suppression, Viremia copy-years, and Viral load > 1,500 copies/ml.
• Assessment of factors associated with non-persistent viral load suppression.

Main Results:

• 87% of 27,706 patients achieved persistent viral load suppression.
• 96% had undetectable viral load at last measurement, but 9.3% lacked consistent long-term suppression.
• Non-persistent suppression linked to younger age, lower education, injection drug use, and lower healthcare continuity.

Conclusions:

• Sustained viral load suppression is a critical indicator for assessing HIV transmission risk.
• Combining sustained viral load suppression with other metrics provides a more accurate risk assessment.
• Identifying at-risk populations is key to improving long-term HIV management.