ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Antiretroviral Therapy Within 2 Years of HIV Acquisition Is Associated With Fewer Viral Blips: A Retrospective Analysis of More Than 20 Years of Data From the US Military HIV Natural History 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 3 papers.
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Who cites it
3 citing papers in PubMed.
- Early intervention, lasting impact: benefits of early antiretroviral therapy and implications for posttreatment control.Current opinion in HIV and AIDS · 2026Review
- New Data and Next Steps for Clarifying How the Timing of Antiretroviral Therapy Initiation Influences Viral Blips and HIV Reservoir Size.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- A Comparison of the Risk of Viral Load Blips in Human Immunodeficiency Virus Patients on Two-Drug Versus Three-Drug Antiretroviral Regimens.Infectious disease reports · 2025Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundViral blips have been associated with larger reservoir size and slower decay. Earlier antiretroviral therapy (ART) initiation may decrease the risk of blips.
methodsWe analyzed participants from the US Military HIV Natural History Study with an estimated human immunodeficiency virus (HIV) seroconversion date, viral suppression ≤400 copies/mL within 1 year after starting ART, and at least 3 HIV RNA measurements after suppression. A blip was defined as HIV RNA 401-1000 copies/mL preceded and followed by HIV RNA ≤400 copies/mL without changing ART. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors potentially associated with the time from viral suppression to first blip.
resultsFrom 1996 through 2022, among 1413 participants on stable suppressive ART, 88 (6.2%) had at least one blip, including 68 (77.3%) with only a single blip. The overall incidence was 1.2 blips per 100 person-years (95% CI: .9-1.4). In multivariable modeling, ART initiation within 24 months of estimated HIV acquisition was independently associated with decreased hazard of viral blips compared with ART initiation after more than 24 months (0-6 months HR: 0.29 and 95% CI: .18-.48; 6-12 months HR: 0.43 and 95% CI: .31-.59; 12-24 months HR: 0.46 and 95% CI: .35-.60).
conclusionsParticipants who initiated ART within 2 years of HIV acquisition had lower hazard of blips, potentially reflecting smaller reservoir size and suggesting reservoir plasticity that extends beyond the acute phase of HIV.
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