ArticlePragmatic and observational research2017
Reduced adherence to antiretroviral therapy is associated with residual low-level viremia.
Article in Pragmatic and observational research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Managing low-level HIV viraemia in antiretroviral therapy: a systematic review and meta-analysis.Sexually transmitted infections · 2024Pooled it
- Effectiveness of intensive adherence counselling in achieving an undetectable viral load among people on antiretroviral therapy with low-level viraemia in Uganda.HIV medicine · 2024Trial
- 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
- Impact of low-level viremia on HIV non-viral load suppression in low and middle-income countries.Annals of medicine and surgery (2012) · 2025Review
- Prevalence and factors associated with HIV viral rebound in individuals on ART: A systematic review study.Journal of public health in Africa · 2025Review
- Viral suppression in adults on efavirenz- or dolutegravir-based antiretroviral therapy in Mopani District, South Africa.Southern African journal of HIV medicine · 2025Article
- Gender and Intersecting Barriers and Facilitators to Access the HIV Cascade of Care in Manitoba, Canada, Before and During the COVID-19 Pandemic: A Qualitative Study.Tropical medicine and infectious disease · 2024Article
- Management of low-level HIV viremia during antiretroviral therapy: Delphi consensus statement and appraisal of the evidence.Sexually transmitted infections · 2024Article
- Dynamics of Low-Level Viremia and Immune Activation after Switching to a Darunavir-Based Regimen.Viruses · 2024Observational
- Influencing factors and adverse outcomes of virologic rebound states in anti-retroviral-treated individuals with HIV infection.Journal of virus eradication · 2023Review
- Hopes, joys and fears: Meaning and perceptions of viral load testing and low-level viraemia among people on antiretroviral therapy in Uganda: A qualitative study.PLOS global public health · 2023Article
- Adherence to antiretroviral therapy thought package-refill among HIV+ persons at "D. Cotugno" hospital, Naples, Italy.Le infezioni in medicina · 2022Article
- Low-level viraemia: An emerging concern among people living with HIV in Uganda and across sub-Saharan Africa.African journal of laboratory medicine · 2022Review
- HIV: how to manage low-level viraemia in people living with HIV.Drugs in context · 2022Review
- Adherence and clinical outcomes of HIV patients switching to a fixed-dose combination regimen.Southern African journal of infectious diseases · 2022Article
- Persistent low-Level viremia in persons living with HIV undertreatment: An unresolved status.Virulence · 2021Review
- Low-Level Viremia Is Associated With Cumulative Adherence to Antiretroviral Therapy in Persons With HIV.Open forum infectious diseases · 2021Article
- Genital Shedding of Human Immunodeficiency Virus Type-1 (HIV) When Antiretroviral Therapy Suppresses HIV Replication in the Plasma.The Journal of infectious diseases · 2020Article
- Impact of low-level viraemia on virological failure among Asian children with perinatally acquired HIV on first-line combination antiretroviral treatment: a multicentre, retrospective cohort study.Journal of the International AIDS Society · 2020Article
- Human Immunodeficiency Virus Drug Resistance: 2018 Recommendations of the International Antiviral Society-USA Panel.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The source and significance of residual low-level viremia (LLV) during combinational antiretroviral therapy (cART) remain a matter of controversy. It is unclear whether residual viremia depends on ongoing release of HIV from the latent reservoir or if viral replication contributes to LLV. We examined the relationship between adherence and LLV. Adherence was estimated by pharmacy refill and dichotomized as ≥95% or <95%. Plasma HIV-RNA was determined, with an ultrasensitive test having a limit of detection of 3 copies/mL at least 2 times over the follow-up period. Patients were grouped according to HIV-RNA over time as K<3: constantly <3 copies/mL; V<3: sometimes below or above the cutoff limit but always <50 copies/mL; K>3: constantly between 3 and 50 copies/mL; and V>50: a measure of >50 copies/mL minimum. Overall, 2789 patients were included. At each time point approximately 92% of the patients presented an HIV-RNA <50 copies/mL and two-thirds of those <3 copies/mL, 34.6% of patients had <3 copies/mL constantly, 32.7% sometimes below or above the cutoff limit but always <50 copies/mL, 9.5% constantly between 3 and 50 copies/mL, and 23.2% a measure of >50 copies/mL minimum. The mean adherence rate was 92.1% (95% confidence interval [CI] from 91.1% to 93.1%) in K<3 patients, similar in V<3 patients (91.9%), but lowered to 88.8% in K>3 patients and to 88.4% in V>50 patients (
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