ReviewCurrent opinion in HIV and AIDS2009
Defining treatment failure in resource-rich settings.
Review in Current opinion in HIV and AIDS, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevalence and predictors of virological failure among the people living with HIV on antiretroviral treatment in East Africa: evidence from a systematic review with meta-analysis and meta-regression of published studies from 2016 to 2023.HIV research & clinical practice · 2025Pooled it
- What leads to treatment failure among people living with HIV: first systematic review from the middle east and North Africa.Virology journal · 2025Pooled it
- Magnitude and causes of first-line antiretroviral therapy regimen changes among HIV patients in Ethiopia: a systematic review and meta-analysis.BMC pharmacology & toxicology · 2019Pooled it
- Effects of incentives on viral suppression in people living with HIV who use cocaine or opiates.Drug and alcohol dependence · 2020Trial
- Influence of episodes of intermittent viremia ("blips") on immune responses and viral load rebound in successfully treated HIV-infected patients.AIDS research and human retroviruses · 2013Trial
- A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes.PLoS medicine · 2011Trial
- The utility of integrating nanopore sequencing into routine HIV-1 drug resistance surveillance.Microbial genomics · 2025Review
- Article
- The spleen is the graveyard of CD4+ cells in patients with immunological failure of visceral leishmaniasis and AIDS.Parasites & vectors · 2024Article
- Article
- Antiretroviral Treatment Failure and Associated Factors Among HIV-Infected Children on Antiretroviral Therapy: A Retrospective Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Time to Immunologic Recovery and Its Determinant Factors Among Adult HIV Patients Who Initiated Antiretroviral Treatment at Hiwot Fana Specialized University Hospital, Harar, Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Patterns of detectable viral load in a cohort of HIV-positive adolescents on antiretroviral therapy in South Africa.Journal of the International AIDS Society · 2020Article
- Incidence and predictors of second-line antiretroviral treatment failure among adults living with HIV in Amhara region: a multi-centered retrospective follow-up study.BMC infectious diseases · 2019Article
- Triggered Escalating Real-Time Adherence Intervention to Promote Rapid HIV Viral Suppression Among Youth Living With HIV Failing Antiretroviral Therapy: Protocol for a Triggered Escalating Real-Time Adherence Intervention.JMIR research protocols · 2019Article
- CD8Frontiers in immunology · 2019Review
- Prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia.BMC immunology · 2018Article
- Factors associated with recent unsuppressed viral load in HIV-1-infected patients in care on first-line antiretroviral therapy in South Africa.International journal of STD & AIDS · 2018Observational
- Comparison of the Aptima HIV-1 Quant Dx assay with the COBAS AmpliPrep/COBAS TaqMan HIV-1 v2.0 Test for HIV-1 viral load quantification in plasma samples from HIV-1-infected patients.Health science reports · 2018Article
- Escape from humoral immunity is associated with treatment failure in HIV-1-infected patients receiving long-term antiretroviral therapy.Scientific reports · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
purpose of reviewTo define treatment failure in resource-rich settings; summarizing current guidelines, assays, the significance of detectable viremia, and definitions of treatment failure in clinical and research settings. RECENT
findingsThe goal of treatment should be full viral suppression, even in highly treatment-experienced patients. SUMMARY: Treatment failure is defined as repeated HIV RNA values above the lower limit of detection of a sensitive assay (usually 50 copies/ml). This criterion is based on evidence that the maximum clinical benefit of antiretroviral therapy is derived by keeping the viral load as low as possible. Full viral suppression should be achievable in all patients, both treatment-naïve and experienced. Transient, low-detectable viremia ('blips') may not predict virologic breakthrough. However, consecutive or higher-level transient viremia is associated with risk of treatment failure. Defining failure by a confirmed HIV RNA more than 50 copies/ml is the most conservative approach, but the use of such low limits of detection in clinical trials may lead to a high false-positive 'failure' rate, thus a definition of 200 copies/ml may be preferable. Variation in clinical trial endpoint definitions creates a challenge for comparing results between studies. For example, using a composite endpoint to define treatment failure may result in a high proportion of 'failures' that are not related to poor virologic response.
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What OpenQuestion holds
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.