ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Virologic Failure Following Low-level Viremia and Viral Blips During Antiretroviral Therapy: Results From a European Multicenter Cohort.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 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
- The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review.Lancet (London, England) · 2023Pooled it
- 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
- Risk of Developing Low-Level Viral Rebound Among People With HIV Receiving 2- or 3-Drug Regimens: A Case-Control Study Nested in the ICONA Cohort.Open forum infectious diseases · 2026Trial
- Efficacy, Safety, and Tolerability of Switching From Bictegravir/Emtricitabine/Tenofovir Alafenamide to Dolutegravir/Lamivudine Among Adults With Virologically Suppressed HIV: The DYAD Study.Open forum infectious diseases · 2024Trial
- 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
- Sustained viral suppression among people with HIV in the era of Undetectable = Untransmittable (U = U) in Australia.AIDS (London, England) · 2026Article
- 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
- 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
- HIV low-level viraemia: considerations for prevention and treatment in an era of highly effective and durable antiretroviral therapy regimens.Journal of the International AIDS Society · 2026Article
- Real-world Prevalence of Nonintegrase INSTI Resistance-Associated Mutations and Virological Outcomes in People Who Have Recently Acquired HIV-1 in the United Kingdom.The Journal of infectious diseases · 2026Article
- Maintain, not obtain: rethinking HIV care in sub-Saharan Africa in the era of dolutegravir.Frontiers in public health · 2026Article
- Article
- Article
- Residual HIV activity and host immunometabolic remodeling during antiretroviral therapy: implications for cardiovascular-kidney-metabolic risk.Frontiers in immunology · 2026Review
- Characterization of drug resistance mutations in people living with HIV with low-level viremia on antiretroviral therapy in Chongqing, China.Frontiers in public health · 2026Article
- 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear whether low-level viremia (LLV), defined as repeatedly detectable viral load (VL) of <200 copies/mL, and/or transient viremic episodes (blips) during antiretroviral therapy (ART), predict future virologic failure. We investigated the association between LLV, blips, and virologic failure (VF) in a multicenter European cohort.
methodsPeople with HIV-1 who started ART in 2005 or later were identified from the EuResist Integrated Database. We analyzed the incidence of VF (≥200 copies/mL) depending on viremia exposure, starting 12 months after ART initiation (grouped as suppression [≤50 copies/mL], blips [isolated VL of 51-999 copies/mL], and LLV [repeated VLs of 51-199 copies/mL]) using Cox proportional hazard models adjusted for age, sex, injecting drug use, pre-ART VL, CD4 count, HIV-1 subtype, type of ART, and treatment experience. We queried the database for drug-resistance mutations (DRM) related to episodes of LLV and VF and compared those with baseline resistance data.
resultsDuring 81 837 person-years of follow-up, we observed 1424 events of VF in 22 523 participants. Both blips (adjusted subhazard ratio [aHR], 1.7; 95% confidence interval [CI], 1.3-2.2) and LLV (aHR, 2.2; 95% CI, 1.6-3.0) were associated with VF, compared with virologic suppression. These associations remained statistically significant in subanalyses restricted to people with VL <200 copies/mL and those starting ART 2014 or later. Among people with LLV and genotype data available within 90 days following LLV, 49/140 (35%) had at least 1 DRM.
conclusionsBoth blips and LLV during ART are associated with increased risk of subsequent VF.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.