Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
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.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis 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
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 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
- Better Longitudinal Adherence to Antiretroviral Therapy Among Virally Suppressed People With HIV Is Associated With Reduced Occurrence of Serious Non-AIDS Events.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
- Effectiveness of switching regimen in people living with HIV and persistent low-level viraemia in the modern antiretroviral treatment era.HIV medicine · 2026Article
- 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
- Article
- Residual HIV activity and host immunometabolic remodeling during antiretroviral therapy: implications for cardiovascular-kidney-metabolic risk.Frontiers in immunology · 2026Review
- 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
- 24-month outcomes after switching to Dolutegravir/Lamivudine in people living with HIV and HBcAb positivity at the Beijing Ditan Hospital in China.Annals of medicine · 2025Article
- Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China.BMC infectious diseases · 2025Article
- HIV Viral Rebound on Dolutegravir, Lopinavir, and Efavirenz: National Program Data Analysis From Ukraine.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Low-level viremia increases the risk of diabetes mellitus in people with HIV in China: a 7-year retrospective longitudinal cohort study.BMC 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
- HIV-1 subtype distribution and drug resistance profiles among PLWHA with detectable viremia in Henan Province, China, 2023.Scientific reports · 2025Article
- 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
- 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
- Characteristics and six-month viral load suppression of clients presenting with advanced HIV disease in South Africa.PLOS global public health · 2025Article
- Persistent low-level viraemia is associated with non-infectious comorbidities in an observational cohort in four African countries.Journal of the International AIDS Society · 2024Observational
- Tobacco smoking, smoking cessation and life expectancy among people with HIV on antiretroviral therapy in South Africa: a simulation modelling study.Journal of the International AIDS Society · 2024Article
- Characteristics of drug resistance mutations in ART-experienced HIV-1 patients with low-level viremia in Zhengzhou City, China.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of low levels of human immunodeficiency virus (HIV) RNA (low-level viremia [LLV]) during combination antiretroviral therapy (cART) on clinical outcomes is unclear. We explored the associations between LLV and all-cause mortality, AIDS, and serious non-AIDS events (SNAEs).
methodsWe grouped individuals starting cART 1996-2017 (identified from the Swedish InfCare HIV register) as virologic suppression (VS; <50 copies/mL), LLV (repeated viral load, 50-999 copies/mL), and nonsuppressed viremia (NSV; ≥1000 copies/mL). Separately, LLV was subdivided into 50-199 and 200-999 copies/mL (reflecting different definitions of virologic failure). Proportional-hazard models (including sex, age, pre-ART CD4 count and viral load, country of birth, injection drug use, treatment experience and interruptions, and an interaction term between viremia and time) were fitted for the study outcomes.
resultsA total of 6956 participants were followed for a median of 5.7 years. At the end of follow-up, 60% were categorized as VS, 9% as LLV, and 31% as NSV. Compared with VS, LLV was associated with increased mortality (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.3-3.6). This association was also observed for LLV 50-199 copies/mL (aHR, 2.2; 95% CI, 1.3-3.8), but was not statistically significant for LLV 200-999 copies/mL (aHR, 2.1; 95% CI, .96-4.7). LLV 50-999 copies/mL was not linked to increased risk of AIDS or SNAEs, but in subanalysis, LLV 200-999 copies/mL was associated with SNAEs (aHR, 2.0; 95% CI, 1.2-3.6).
conclusionsIn this population-based cohort, LLV during cART was associated with adverse clinical outcomes.
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