ArticlePloS one2017
Virological failure and all-cause mortality in HIV-positive adults with low-level viremia during antiretroviral treatment.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers.
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Who cites it
38 citing papers in PubMed.
- 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
- Low-level viremia in people with HIV in Ethiopia is associated with subsequent lack of viral suppression and attrition from care.Global health action · 2025Article
- Characterization of Antiretroviral Therapy (ART) Adherence Phenotypes and Psychosocial Symptom Clusters Among Black/African American (AA) and Hispanic/Latine Adolescents and Young Adults (AYAs) with HIV in the Adherence Connection for Counseling, Education, and Support (ACCESS-II) Trial.Tropical medicine and infectious disease · 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
- The urgent need for newer drugs in routine HIV treatment in Africa: the case of Ghana.Frontiers in epidemiology · 2025Review
- HIV Low-Level Viremia is Not Related to Subsequent Virological Failure Under NNRTI-Based Regimens: A Multicenter Retrospective Study in China.Infection and drug resistance · 2025Article
- Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China.Frontiers in public health · 2025Article
- Low Level Viremia Is Associated With Serious non-AIDS Events in People With HIV.Open forum infectious diseases · 2024Article
- Incidence of low-level viremia and its impact on virologic failure among people living with HIV who started an integrase strand transfer inhibitors: a longitudinal cohort study.BMC infectious diseases · 2024Article
- The Interrelationship between HIV Infection and COVID-19: A Review of the Literature.Current HIV research · 2024Review
- Clinical Outcomes After Viremia Among People Receiving Dolutegravir vs Efavirenz-Based First-line Antiretroviral Therapy in South Africa.Open forum infectious diseases · 2023Article
- Retrospective longitudinal analysis of low-level viremia among HIV-1 infected adults on antiretroviral therapy in Kenya.EClinicalMedicine · 2023Article
- Cohort profile: InfCareHIV, a prospective registry-based cohort study of people with diagnosed HIV in Sweden.BMJ open · 2023Article
- Influencing factors and adverse outcomes of virologic rebound states in anti-retroviral-treated individuals with HIV infection.Journal of virus eradication · 2023Review
- Virologic Failure Following Low-level Viremia and Viral Blips During Antiretroviral Therapy: Results From a European Multicenter Cohort.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- HIV Virologic Failure among Patients with Persistent Low-Level Viremia in Nairobi, Kenya: It Is Time to Review the >1000 Virologic Failure Threshold.BioMed research international · 2023Article
- Lived experience of people on anti-retro viral therapy in the context of covid-19: A phenomenological study.PloS one · 2023Article
- A Framework for Descriptive Epidemiology.American journal of epidemiology · 2022Article
- The Impact of Low-Level Viraemia on Virological Failure-Results From a Multicenter HIV Antiretroviral Therapy Cohort Study in Yunnan, China.Frontiers in medicine · 2022Article
- Factors associated with low-level viraemia in people with HIV starting antiretroviral therapy: A Swedish observational study.PloS one · 2022Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAlthough most HIV-infected individuals achieve undetectable viremia during antiretroviral therapy (ART), a subset have low-level viremia (LLV) of varying duration and magnitude. The impact of LLV on treatment outcomes is unclear. We investigated the association between LLV and virological failure and/or all-cause mortality among Swedish patients receiving ART.
methodsHIV-infected patients from two Swedish HIV centers were identified from the nationwide register InfCare HIV. Subjects aged ≥15 years with triple agent ART were included at 12 months after treatment initiation if ≥2 following viral load measurements were available. Patients with 2 consecutive HIV RNA values ≥1000 copies/mL at this time point were excluded. Participants were stratified into four categories depending on viremia profiles: permanently suppressed viremia (<50 copies/mL), LLV 50-199 copies/mL, LLV 200-999 copies/mL and viremia ≥1000 copies/mL. Association between all four viremia categories and all-cause death was calculated using survival analysis with viremia as a time-varying covariate, so that patients could change viremia category during follow-up. Association between the three lower categories and virological failure (≥2 consecutive measurements ≥1000 copies/mL) was calculated in a similar manner.
resultsLLV 50-199 copies/mL was recorded in 70/1015 patients (6.9%) and LLV 200-999 copies/mL in 89 (8.8%) during 7812 person-years of follow-up (median 6.5 years). LLV 200-999 copies/mL was associated with virological failure (adjusted hazard ratio 3.14 [95% confidence interval 1.41-7.03, p<0.01]), whereas LLV 50-199 copies/mL was not (1.01 [0.34-4.31, p = 0.99]; median follow-up 4.5 years). LLV 200-999 copies/mL had an adjusted mortality hazard ratio of 2.29 (0.98-5.32, p = 0.05) and LLV 50-199 copies/mL of 2.19 (0.90-5.37, p = 0.09).
conclusionsIn this Swedish cohort followed during ART for a median of 4.5 years, LLV 200-999 copies/mL was independently associated with virological failure. Patients with LLV had higher rates of all-cause mortality, although not statistically significant in multivariate analysis.
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