ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Persistent Low-level Viremia While on Antiretroviral Therapy Is an Independent Risk Factor for Virologic Failure.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers.
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Who cites it
62 citing papers in PubMed.
- Analysis of Viral Blips Through Week 192 of the DRIVE-FORWARD and DRIVE-AHEAD Phase 3 Studies of Doravirine-Based Regimens in Adults Living With Previously Untreated HIV-1.Open forum infectious diseases · 2026Trial
- Switch to second-line versus continued first-line antiretroviral therapy for patients with low-level HIV-1 viremia: An open-label randomized controlled trial in Lesotho.PLoS medicine · 2020Trial
- Optimising Post-Delivery Viral Load Monitoring and HIV Care to Eliminate Breastfeeding-Associated HIV Transmission in Sub-Saharan Africa: A Review.Tropical medicine and infectious disease · 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
- Variability in HIV viral load quantification in real-world service delivery settings: findings from an observational cohort study in Rwanda.BMC infectious diseases · 2026Observational
- Article
- Gastrointestinal Mucosal Disruptions During ART-Treated SIVPathogens & immunity · 2026Article
- Artificial intelligence in HIV research: a structured review and task-oriented clinical framework.Frontiers in digital health · 2026Review
- Article
- 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
- Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China.BMC infectious diseases · 2025Article
- HIV-1 Low-Level Viremia Predicts Viral Failure in Participants on Antiretroviral Therapy in the Swiss HIV Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Higher levels of cell-associated HIV-1 RNA transcripts predict risk of viral blips: implications for clinical management and cure research.AIDS (London, England) · 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
- Impact of low-level viremia on HIV non-viral load suppression in low and middle-income countries.Annals of medicine and surgery (2012) · 2025Review
- Low-level viraemia as a risk factor for virologic failure in children and adolescents living with HIV on antiretroviral therapy in Tanzania: a multicentre, retrospective cohort study.Journal of the International AIDS Society · 2025Article
- Association of HIV low-level viremia with CD4 count recovery among persons living with HIV during antiretroviral therapy in Dehong Prefecture, Southwest China in 2008-2021: a longitudinal study.BMC infectious diseases · 2025Article
- Molecular characterization of HIV-1 near-full-length proviral quasispecies in monocytes from patients across different virological responses.Frontiers in microbiology · 2025Article
- Factors affecting viral suppression or rebound in people living with HIV and receiving antiretroviral therapy in Ghana.Frontiers in public health · 2025Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether persistent low-level viremia (pLLV) predicts virologic failure (VF) is unclear. We used data from the US Military HIV Natural History Study (NHS), to examine the association of pLLV and VF.
methodsNHS subjects who initiated combination antiretroviral therapy (ART) after 1996 were included if they had 2 or more VLs measured with a lower limit of detection of ≤50 copies/mL. VF was defined as a confirmed VL ≥200 copies/mL or any VL >1000 copies/mL. Participants were categorized into mutually exclusive virologic categories: intermittent LLV (iLLV) (VL of 50-199 copies/mL on <25% of measurements), pLLV (VL of 50-199 copies/mL on ≥25% of measurements), high-level viremia (hLV) (VL of 200-1000 copies/mL), and continuous suppression (all VL <50 copies/mL). Cox proportional hazards models were used to evaluate the association between VF and LLV; hazard ratios and 95% confidence interval (CI) are presented.
resultsTwo thousand six subjects (median age 29.2 years, 93% male, 41% black) were included; 383 subjects (19%) experienced VF. After adjusting for demographics, VL, CD4 counts, ART regimen, prior use of mono or dual antiretrovirals, and time to ART start, pLLV (3.46 [2.42-4.93]), and hLV (2.29 [1.78-2.96]) were associated with VF. Other factors associated with VF include black ethnicity (1.33 [1.06-1.68]) and antiretroviral use prior to ART (1.79 [1.34-2.38]). Older age at ART initiation (0.71 [0.61-0.82]) and non-nucleoside reverse transcriptase inhibitor (0.68 [0.51-0.90]) or integrase strand transfer inhibitor use (0.26 [0.13-0.53]) were protective.
conclusionOur data add to the body of evidence that suggests persistent LLV is associated with deleterious virologic consequences.
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