ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Plasma Human Immunodeficiency Virus 1 RNA and CD4+ T-Cell Counts Are Determinants of Virological Nonsuppression Outcomes With Initial Integrase Inhibitor-Based Regimens: A Prospective RESPOND Cohort Study.
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 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Virologic Failure and Emergent Integrase Strand Transfer Inhibitor Drug Resistance With Long-Acting Cabotegravir for HIV Treatment: A Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- VOGUE: Noninferior Efficacy of Dolutegravir/Lamivudine Versus Bictegravir/Emtricitabine/Tenofovir Alafenamide in Adults With HIV-1 Naive to Treatment.Open forum infectious diseases · 2026Trial
- Efficacy and Safety Outcomes in Adults Initiating Dolutegravir/Lamivudine With High Viral Load in the GEMINI-1/-2 and STAT Trials.Open forum infectious diseases · 2025Trial
- Comparable efficacy of bictegravir/emtricitabine/tenofovir alafenamide and doravirine/lamivudine/tenofovir disoproxil fumarate in therapy-naive Human Immunodeficiency Virus adults with very high baseline viraemia.Journal of medical microbiology · 2026Article
- Efficacy and predictors of virological non-suppression in Thailand's rollout of dolutegravir-based first-line antiretroviral therapy: A nationwide cohort analysis.HIV medicine · 2026Article
- Article
- Clinical presentation and effectiveness of antiretroviral therapy in newly diagnosed people living with HIV before, during and after the COVID-19 pandemic.BMJ public health · 2026Article
- HIV-1 drug resistance and associated risk factors in patients with antiretroviral therapy failure in Chongqing, China, 2019-2023.PloS one · 2026Article
- 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
- 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
- Effect of Machine Learning on Risk Stratification for Antiretroviral Treatment Failure in People Living with HIV.Infection and drug resistance · 2025Article
- HDL-C as a novel predictor of immune reconstitution in people living with HIV: insights from a baseline-to-dynamic change cohort study in China, 2005-2022.Frontiers in immunology · 2025Article
- Characteristics of drug resistance mutations in ART-experienced HIV-1 patients with low-level viremia in Zhengzhou City, China.Scientific reports · 2024Article
- Detectable Virological Load and Associated Factors among People Living with HIV on Antiretroviral Treatment: A Retrospective Study.Pathogens (Basel, Switzerland) · 2024Article
- Laboratory Report of HIV-1 Low-Level Viremia.Open forum infectious diseases · 2024Article
- Risk factors and clinical prediction models for low-level viremia in people living with HIV receiving antiretroviral therapy: an 11-year retrospective study.Frontiers in microbiology · 2024Article
- Investigating rates and predictors of viral blips, low-level viraemia and virological failure in the Australian HIV observational database.Tropical medicine & international health : TM & IH · 2024Article
- Validation of a Risk Prediction Nomogram for Virologic Failure Among Patients on First-Line ART After ONE-J Program Implementation in Northwest Ethiopia.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
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Authors and funding
33 authors at 20 institutions in 14 countries.
Funding
Abstract
backgroundThere are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort.
methodsWe included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020. We assessed the odds of virological suppression (VS) at weeks 48 and 96 using logistic regression. Viral blips, low-level viremia (LLV), residual viremia (RV), and virological failure (VF) rates were assessed using Cox regression.
resultsOf 4310 eligible participants, 72% started integrase strand transfer inhibitor (INSTI)-based regimens. At 48 and 96 weeks, 91.0% and 93.3% achieved VS, respectively. At 48 weeks, Kaplan-Meier estimates of rates were 9.6% for viral blips, 2.1% for LLV, 22.2% for RV, and 2.1% for VF. Baseline HIV-1 RNA levels >100 000 copies/mL and CD4+ T-cell counts ≤200/µL were negatively associated with VS at weeks 48 (adjusted odds ratio, 0.51 [95% confidence interval, .39-.68] and .40 [.27-.58], respectively) and 96 and with significantly higher rates of blips, LLV, and RV. CD4+ T-cell counts ≤200/µL were associated with higher risk of VF (adjusted hazard ratio, 3.12 [95% confidence interval, 2.02-4.83]). Results were consistent in those starting INSTIs versus other regimens and those starting dolutegravir versus other INSTIs.
conclusionsInitial high HIV-1 RNA and low CD4+ T-cell counts are associated with lower rates of VS at 48 and 96 weeks and higher rates of viral blips, LLV, and RV. Low baseline CD4+ T-cell counts are associated with higher VF rates. These associations remain with INSTI-based and specifically with dolutegravir-based regimens. These findings suggest that the impact of these baseline determinants is independent of the ART regimen initiated.
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