ArticleJournal of the International Association of Providers of AIDS Care
Plasma Viral Load of 200 Copies/mL is a Suitable Threshold to Define Viral Suppression and HIV Drug Resistance Testing in Low- and Middle-Income Countries: Evidence From a Facility-Based Study in Cameroon.
Article in Journal of the International Association of Providers of AIDS Care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Sustained viral suppression among people with HIV in the era of Undetectable = Untransmittable (U = U) in Australia.AIDS (London, England) · 2026Article
- Characterization of human immunodeficiency virus drug-resistance mutations among individuals with low-level-viremia in low-income and middle-income countries: A meta-analysis.World journal of virology · 2026Article
- 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
- Acquired HIV-1 drug resistance to reverse transcriptase and protease inhibitors among people failing antiretroviral therapy in Cameroon and implications for future treatment options.AIDS research and therapy · 2025Article
- Factors Associated With Viral Load Suppression Among Adults on Dolutegravir and Efavirenz: A Cross-Sectional Study in Papua, Indonesia.Journal of the International Association of Providers of AIDS CareArticle
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31 authors.
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Abstract
introductionIn low-and-middle-income-countries (LMIC), viral suppression is defined as plasma viral load (PVL) below 1000 copies/mL (low-level viremia [LLV]) and threshold for HIV drug resistance (HIVDR) testing. However, there is evidence that drug resistance mutations (DRMs) may emerge at LLV, thus compromising antiretroviral treatment (ART) response
methodsA cross-sectional study was conducted among individuals with LLV at the Chantal BIYA International Reference Centre, Yaoundé, Cameroon from January 2020 through August 2021. HIV-1 sequencing was performed on protease/reverse-transcriptase, and sequences analysed using Stanford HIVdbv9.5. SSR and HIVDR rates were assessed according to viral-load ranges, with
resultsIn total, 131 individuals were enrolled (median [IQR] age = 41 [30-49] years; 67.9% female; 54.7% at WHO clinical-stage I/II; median ART-duration 7 [4-11] years; median CD4-count 221 [103-402] cells/mm
conclusionIn this LMIC context, sequencing for HIVDR is feasible at LLV even with broad HIV-1 diversity, with significantly higher SSR above 150 copies/mL and/or in paediatrics. About 80% of individuals with LLV harbour HIVDR strains, with half of them needing ART optimisations to limit HIVDR emergence and prevent treatment failure. Our findings underscore the clinical benefits of HIVDR during persisting LLV and the need to reconsider the threshold for viral suppression around 200copies/mL in LMICs.
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