ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Performance of HIV-1 drug resistance testing at low-level viremia and its ability to predict future virologic outcomes and viral evolution in treatment-naive individuals.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 98 citations in OpenAlex.
- Managing low-level HIV viraemia in antiretroviral therapy: a systematic review and meta-analysis.Sexually transmitted infections · 2024Pooled it
- Association between first-year virological response to raltegravir and long-term outcomes in treatment-experienced patients with HIV-1 infection.Antiviral therapy · 2015Trial
- Diagnostic and Therapeutic Perspectives on Persistent HIV-1 Low-Level Viremia.Infection & chemotherapy · 2026Review
- Impact of HIV-1 low-level viremia on virologic and immunologic failure during antiretroviral therapy: a retrospective cohort study from 2005 to 2023 in Qinzhou City, Guangxi, China.AIDS research and therapy · 2026Article
- High frequency of HIV-1 drug resistance among individuals with persistent low-level viremia during first-line antiretroviral therapy in Uganda.BMC infectious diseases · 2026Article
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- A Guide to the Evolving Clinical Landscape of Low-Level Viremia Among Persons with HIV in the Modern Treatment Era.Current HIV/AIDS reports · 2025Review
- Management of low-level HIV viremia during antiretroviral therapy: Delphi consensus statement and appraisal of the evidence.Sexually transmitted infections · 2024Article
- Comparison of Different HIV-1 Resistance Interpretation Tools for Next-Generation Sequencing in Italy.Viruses · 2024Article
- Characteristics of drug resistance mutations in ART-experienced HIV-1 patients with low-level viremia in Zhengzhou City, China.Scientific reports · 2024Article
- Low Level Viremia Is Associated With Serious non-AIDS Events in People With HIV.Open forum infectious diseases · 2024Article
- High prevalence of pre-treatment and acquired HIV-1 drug resistance mutations among non-citizens living with HIV in Botswana.Frontiers in microbiology · 2024Article
- Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011-2022: A Retrospective Study.Infection and drug resistance · 2023Article
- Genotypic Resistance Testing of HIV-1 DNA in Peripheral Blood Mononuclear Cells.Clinical microbiology reviews · 2022Review
- HIV-1 drug resistance genotyping success rates and correlates of Dried-blood spots and plasma specimen genotyping failure in a resource-limited setting.BMC infectious diseases · 2022Article
- HIV-1 drug resistance mutations among individuals with low-level viraemia while taking combination ART in Botswana.The Journal of antimicrobial chemotherapy · 2022Article
- HIV-1C in-House RNA-Based Genotyping Assay for Detection of Drug Resistance Mutations in Samples with Low-Level Viral Loads.Infection and drug resistance · 2022Article
- HIV-1 Genotypic Resistance Testing Using Sanger and Next-Generation Sequencing in Adults with Low-Level Viremia in China.Infection and drug resistance · 2022Article
- Persistent low-Level viremia in persons living with HIV undertreatment: An unresolved status.Virulence · 2021Review
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8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundLow-level viremia (LLV; human immunodeficiency virus [HIV-1] RNA 50-999 copies/mL) occurs frequently in patients receiving antiretroviral therapy (ART), but there are few or no data available demonstrating that HIV-1 drug resistance testing at a plasma viral load (pVL) <1000 copies/mL provides potentially clinically useful information. Here, we assess the ability to perform resistance testing by genotyping at LLV and whether it is predictive of future virologic outcomes in patients beginning ART.
methodsResistance testing by genotyping at LLV was attempted on 4915 plasma samples from 2492 patients. A subset of previously ART-naive patients was analyzed who achieved undetectable pVL and subsequently rebounded with LLV (n = 212). A genotypic sensitivity score (GSS) was calculated based on therapy and resistance testing results by genotyping, and stratified according to number of active drugs.
resultsEighty-eight percent of LLV resistance assays produced useable sequences, with higher success at higher pVL. Overall, 16 of 212 (8%) patients had pretherapy resistance. Thirty-eight of 196 (19%) patients without pretherapy resistance evolved resistance to 1 or more drug classes, primarily the nucleoside reverse transcriptase (14%) and/or nonnucleoside reverse transcriptase (9%) inhibitors. Patients with resistance at LLV (GSS <3) had a 2.1-fold higher risk of virologic failure (95% confidence interval, 1.2- to 3.7-fold) than those without resistance (P = .007). Progressively lower GSS scores at LLV were associated with a higher increase in pVL over time (P < .001). Acquisition of additional resistance mutations to a new class of antiretroviral drugs during LLV was not found in a subset of patients.
conclusionsRoutine HIV-1 genotyping of LLV samples can be performed with a reasonably high success rate, and the results appear predictive of future virologic outcomes.
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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.