ArticleAIDS (London, England)2018
Monotypic low-level HIV viremias during antiretroviral therapy are associated with disproportionate production of X4 virions and systemic immune activation.
Article in AIDS (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- 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
- Risk Factors Associated with Virological Failure in HIV Patients with Low Level Viremia: A Retrospective Study.Infection and drug resistance · 2025Article
- Management of low-level HIV viremia during antiretroviral therapy: Delphi consensus statement and appraisal of the evidence.Sexually transmitted infections · 2024Article
- Low-level viremia episodes appear to affect the provirus composition of the circulating cellular HIV reservoir during antiretroviral therapy.Frontiers in microbiology · 2024Article
- Viral and host mediators of non-suppressible HIV-1 viremia.Nature medicine · 2023Article
- 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
- Cardiovascular Profile of South African Adults with Low-Level Viremia during Antiretroviral Therapy.Journal of clinical medicine · 2022Article
- All-Cause Mortality and Serious Non-AIDS Events in Adults With Low-level Human Immunodeficiency Virus Viremia During Combination Antiretroviral Therapy: Results From a Swedish Nationwide Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Observational
- Genital Shedding of Human Immunodeficiency Virus Type-1 (HIV) When Antiretroviral Therapy Suppresses HIV Replication in the Plasma.The Journal of infectious diseases · 2020Article
- Cells producing residual viremia during antiretroviral treatment appear to contribute to rebound viremia following interruption of treatment.PLoS pathogens · 2020Observational
- Upregulation of IL-32 Isoforms in Virologically Suppressed HIV-Infected Individuals: Potential Role in Persistent Inflammation and Transcription From Stable HIV-1 Reservoirs.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Amino Acid Prevalence of HIV-1AIDS research and human retroviruses · 2019Article
- Phylogenetic Analyses Comparing HIV Sequences from Plasma at Virologic Failure to Cervix Versus Blood Sequences from Antecedent Antiretroviral Therapy Suppression.AIDS research and human retroviruses · 2019Observational
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 3 countries.
Funding
Abstract
objectiveDuring effective antiretroviral therapy (ART), low-level plasma viremias (LLV) (HIV RNA >30-1000 copies/ml) can be detected intermittently. We hypothesized that systemic inflammation is associated with LLV either as the cause or result of the production of virions from clonally expanded cells.
methodsProspective cohort study of HIV-infected ART-naive Peruvians enrolled prior to ART and followed for 2 years. Plasma HIV RNA and peripheral blood mononuclear cell (PBMC) HIV DNA concentrations were quantified pre-ART from individuals whose plasma HIV RNA was ART-suppressed. Inflammatory biomarker concentrations were measured pre and during ART. Single-genome amplification (SGA) derived HIV env and pol genotypes from pre-ART and LLV specimens. Antiretroviral levels during ART assessed adherence. Statistical associations and phylogenetic relationships were examined.
resultsAmong 82 participants with median plasma HIV RNA less than 30 copies/ml, LLV were detected in 33 of 82 (40%), with a LLV median HIV RNA of 73 copies/ml. Participants with vs. without LLV had significantly higher pre-ART plasma HIV RNA (P < 0.001) and PBMC HIV DNA (P < 0.007); but, during ART, their antiretroviral drug levels were similar. LLV env sequences were monotypic in 17 of 28 (61%) and diverse in 11 of 28 (39%) participants. Those with the monotypic vs. diverse LLV pattern had elevated hsCRP and sCD163 (P = 0.004) and LLV with more X4 variants (P = 0.02).
conclusionIn individuals with monotypic LLV sequences, higher levels of pre-ART HIV DNA and RNA, systemic inflammation and X4 viruses suggest an interaction between inflammation and the production of virions from proliferating infected cells, and that naïve T cells may be a source of LLV.
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