RT Journal Article
T1 Virologic Failure Following Low-level Viremia and Viral Blips During Antiretroviral Therapy: Results From a European Multicenter Cohort.
A1 Elvstam, Olof
A1 Malmborn, Kasper
A1 Elen, Sixten
A1 Marrone, Gaetano
A1 Garcia, Federico
A1 Zazzi, Maurizio
A1 Sönnerborg, Anders
A1 Böhm, Michael
A1 Seguin-Devaux, Carole
A1 Björkman, Per
K1 HIV-1
K1 low-level viremia
K1 treatment failure
K1 viral blips
AB It is unclear whether low-level viremia (LLV), defined as repeatedly detectable viral load (VL) of  People 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. During 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  Both blips and LLV during ART are associated with increased risk of subsequent VF.
PB Oxford University Press
YR 202-
FD 202-09-05
LK http://hdl.handle.net/10668/19738
UL http://hdl.handle.net/10668/19738
LA en
NO Elvstam O, Malmborn K, Elén S, Marrone G, García F, Zazzi M, et al. Virologic Failure Following Low-level Viremia and Viral Blips During Antiretroviral Therapy: Results From a European Multicenter Cohort. Clin Infect Dis. 2023 Jan 6;76(1):25-31.
DS RISalud
RD Apr 18, 2025