ArticleProceedings of the National Academy of Sciences of the United States of America2009
Treatment intensification does not reduce residual HIV-1 viremia in patients on highly active antiretroviral therapy.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01295515 (Effect of Interferon Alpha 2b Intensification on HIV-1 Residual Viremia in Individuals Suppressed on Antiretroviral Therapy), which is not on this map. Cited by 277 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Interferon Alpha 2b Intensification on HIV-1 Residual Viremia in Individuals Suppressed on Antiretroviral Therapy
Who cites it
277 citing papers in PubMed, 1 synthesis or guideline pooled it, 442 citations in OpenAlex.
- Managing low-level HIV viraemia in antiretroviral therapy: a systematic review and meta-analysis.Sexually transmitted infections · 2024Pooled it
- Doubling dolutegravir dosage reduces the viral reservoir in ART-treated people with HIV.eLife · 2026Trial
- Trial
- Size, Composition, and Evolution of HIV DNA Populations during Early Antiretroviral Therapy and Intensification with Maraviroc.Journal of virology · 2018Trial
- No evidence of HIV replication in children on antiretroviral therapy.The Journal of clinical investigation · 2017Trial
- Peripheral T Follicular Helper Cells Are the Major HIV Reservoir within Central Memory CD4 T Cells in Peripheral Blood from Chronically HIV-Infected Individuals on Combination Antiretroviral Therapy.Journal of virology · 2015Trial
- Virologic and immunologic effects of adding maraviroc to suppressive antiretroviral therapy in individuals with suboptimal CD4+ T-cell recovery.AIDS (London, England) · 2015Trial
- HIV-1 DNA decay dynamics in blood during more than a decade of suppressive antiretroviral therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Trial
- A randomized open-label study of 3- versus 5-drug combination antiretroviral therapy in newly HIV-1-infected individuals.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- The HIV-1 reservoir in eight patients on long-term suppressive antiretroviral therapy is stable with few genetic changes over time.Proceedings of the National Academy of Sciences of the United States of America · 2013Trial
- Three distinct phases of HIV-1 RNA decay in treatment-naive patients receiving raltegravir-based antiretroviral therapy: ACTG A5248.The Journal of infectious diseases · 2013Trial
- Modelling HIV-1 2-LTR dynamics following raltegravir intensification.Journal of the Royal Society, Interface · 2013Trial
- Administration of a Toll-like receptor 9 agonist decreases the proviral reservoir in virologically suppressed HIV-infected patients.PloS one · 2013Trial
- Diagnostic and Therapeutic Perspectives on Persistent HIV-1 Low-Level Viremia.Infection & chemotherapy · 2026Review
- 5' leader defects drive persistent HIV-1 viremia on long-term ART.Nature communications · 2026Article
- Comparison of manual and automated ultrasensitive assays for residual HIV-1 in plasma from individuals on suppressive antiretroviral therapy.Journal of clinical microbiology · 2025Article
- Combining spironolactone to antiretroviral therapy accelerates HIV decay in humanized mice.Emerging microbes & infections · 2025Article
- Doubling dolutegravir dosage reduces the viral reservoir in ART-treated people with HIV.medRxiv : the preprint server for health sciences · 2025Article
- Mild HIV-specific selective forces overlaying natural CD4+ T cell dynamics explain the clonality and decay dynamics of HIV reservoir cells.Cell systems · 2025Article
- HIV-1 RNA in Large and Small Plasma Extracellular Vesicles: A Novel Parameter for Monitoring Immune Activation and Virological Failure.Journal of medical virology · 2025Article
217 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 8 institutions in 2 countries.
Funding
Abstract
In HIV-1-infected individuals on currently recommended antiretroviral therapy (ART), viremia is reduced to <50 copies of HIV-1 RNA per milliliter, but low-level residual viremia appears to persist over the lifetimes of most infected individuals. There is controversy over whether the residual viremia results from ongoing cycles of viral replication. To address this question, we conducted 2 prospective studies to assess the effect of ART intensification with an additional potent drug on residual viremia in 9 HIV-1-infected individuals on successful ART. By using an HIV-1 RNA assay with single-copy sensitivity, we found that levels of viremia were not reduced by ART intensification with any of 3 different antiretroviral drugs (efavirenz, lopinavir/ritonavir, or atazanavir/ritonavir). The lack of response was not associated with the presence of drug-resistant virus or suboptimal drug concentrations. Our results suggest that residual viremia is not the product of ongoing, complete cycles of viral replication, but rather of virus output from stable reservoirs of infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.