ArticleAntimicrobial agents and chemotherapy2014
Significance and clinical management of persistent low-level viremia and very-low-level viremia in HIV-1-infected patients.
Article in Antimicrobial agents and chemotherapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
81 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevalence of low-level viremia and related influencing factors among people living with HIV in China: a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Managing low-level HIV viraemia in antiretroviral therapy: a systematic review and meta-analysis.Sexually transmitted infections · 2024Pooled it
- Guideline
- Risk of Developing Low-Level Viral Rebound Among People With HIV Receiving 2- or 3-Drug Regimens: A Case-Control Study Nested in the ICONA Cohort.Open forum infectious diseases · 2026Trial
- Viral load care of HIV-1 infected children and adolescents: A longitudinal study in rural Zimbabwe.PloS one · 2021Trial
- Trial
- Characteristics and management of low-level viraemia in people living with HIV in a resource-limited setting: A multicentre retrospective study in Greece.HIV medicine · 2026Observational
- Diagnostic and Therapeutic Perspectives on Persistent HIV-1 Low-Level Viremia.Infection & chemotherapy · 2026Review
- Different Trends of Immune Activation Markers When Switching to Either Oral or Injectable Dual Antiretroviral Therapy Based on Integrase Inhibitors in People Living with HIV.Pathogens (Basel, Switzerland) · 2026Article
- Article
- Machine learning quantifies immuno-virological interactions: a TRIPOD+AI compliant prediction model for HIV-1 salvage therapy outcomes.Frontiers in immunology · 2026Article
- Proviruses in CD4Science translational medicine · 2025Article
- 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
- Is there a relationship between the route of HIV transmission and cognitive performance in older individuals living with HIV?Archives of public health = Archives belges de sante publique · 2025Article
- Impact of low-level viremia on HIV non-viral load suppression in low and middle-income countries.Annals of medicine and surgery (2012) · 2025Review
- Cryo-EM Structure of HIV-1 Reverse Transcriptase withACS infectious diseases · 2025Article
- Implementation of pooled testing to increase access to routine viral load monitoring for people living with HIV on antiretroviral therapy.Scientific reports · 2025Article
- Therapeutic efficacy of albuvirtide-based antiretroviral therapy in people living with HIV who have low-level viremia and non-AIDS-defining malignancies: two case reports.Retrovirology · 2025Article
- Using data science to investigate rising HIV low-level viraemia results at Groote Schuur laboratory in South Africa.African journal of laboratory medicine · 2025Article
- Low-Level Viremia as an Independent Risk Factor for Metabolic Syndrome in People Living with HIV Receiving Antiretroviral Therapy: A 6-Year Retrospective Cohort Study.Infection and drug resistance · 2025Article
21 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A goal of HIV therapy is to sustain suppression of the plasma viral load below the detection limits of clinical assays. However, widely followed treatment guidelines diverge in their interpretation and recommended management of persistent viremia of low magnitude, reflecting the limited evidence base for this common clinical finding. Here, we review the incidence, risk factors, and potential consequences of low-level HIV viremia (LLV; defined in this review as a viremia level of 50 to 500 copies/ml) and very-low-level viremia (VLLV; defined as a viremia level of <50 copies/ml detected by clinical assays that have quantification cutoffs of <50 copies/ml). Using this framework, we discuss practical issues related to the diagnosis and management of patients experiencing persistent LLV and VLLV. Compared to viral suppression at <50 or 40 copies/ml, persistent LLV is associated with increased risk of antiretroviral drug resistance and overt virologic failure. Higher immune activation and HIV transmission may be additional undesirable consequences in this population. It is uncertain whether LLV of <200 copies/ml confers independent risks, as this level of viremia may reflect assay-dependent artifacts or biologically meaningful events during suppression. Resistance genotyping should be considered in patients with persistent LLV when feasible, and treatment should be modified if resistance is detected. There is a dearth of clinical evidence to guide management when genotyping is not feasible. Increased availability of genotypic assays for samples with viral loads of <400 copies/ml is needed.
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