ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
HIV-1 Low-Level Viremia Predicts Viral Failure in Participants on Antiretroviral Therapy in the Swiss HIV Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Association Between Different Levels of Suppressed Viral Load and the Risk of Sexual Transmission of HIV Among Serodiscordant Couples on Antiretroviral Therapy: A Systematic Review.AIDS and behavior · 2026Pooled it
- Article
- Article
- Similar Changes in Proviral Landscapes Over 10 Years in 40 Individuals With Diverging HIV Reservoir Dynamics and Viral Load Kinetics.Open forum infectious diseases · 2026Article
- 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
- Residual HIV activity and host immunometabolic remodeling during antiretroviral therapy: implications for cardiovascular-kidney-metabolic risk.Frontiers in immunology · 2026Review
- Artificial intelligence in HIV research: a structured review and task-oriented clinical framework.Frontiers in digital health · 2026Review
- Article
- Research progress on HIV-1 structural proteins and antiviral therapies.Frontiers in immunology · 2026Review
- Characteristics and six-month viral load suppression of clients presenting with advanced HIV disease in South Africa.PLOS global public health · 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
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Authors and funding
14 authors.
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Abstract
backgroundMost individuals receiving combination antiretroviral therapy (ART) have human immunodeficiency virus (HIV) plasma viral loads below the limit of detection. However, episodes of low-level viremia (LLV) are observed in subsets of individuals, the risk factors and clinical significance of which remain debated.
methodsWe included participants enrolled in the Swiss HIV Cohort Study, starting ART between July 1999 and April 2023, with HIV RNA values <200 copies/mL 6 months after ART initiation. Using longitudinally collected data, we applied a time-updated Cox proportional hazards model to determine the association of LLV with the risk of subsequent viral failure, defined as ≥200 copies/mL. LLV was quantified by the time-updated area under the curve (AUC) of HIV RNA values, categorized as undetectable or, based on AUC tertiles, low, intermediate, or high.
resultsWe included 8132 participants with a total of 49 579 person-years of follow-up. The median follow-up time was 4.7 years, and the median number of HIV RNA measurements was 16. Participants had a median age of 38 years, 75.9% were male, 74.4% were white, and 45.9% had HIV-1 subtype B. LLV was associated with an increased risk of subsequent viral failure, with the highest LLV category showing the strongest association (hazard ratio, 3.3 [for comparison with undetectable viral load]) among all included variables, including race/ethnicity, age, and ART.
conclusionsLLV was strongly associated with risk of subsequent viral failure, even after adjustment for demographic and clinical characteristics, including adherence and treatment regimen. The detection of LLV should prompt appropriate measures to decrease the risk of subsequent viral failure.
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