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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Residual Viremia is preceding viral blips and persistent low-level Viremia in treated HIV-1 patients
PLoS ONE, Volume 9, No. 10, Article e110749, Year 2014
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Description
Background: It has been suggested that low-level viremia or blips in HIV-infected patients on antiretroviral treatment are related to assay variation and/or increased sensitivity of new commercial assays. The 50-copy cut-off for virologic failure is, therefore, under debate.; Methods: Treated patients with low-level viremia (persistent viral loads (VL) of 50-1000 copies/mL, group A, N = 16) or a blip (single detectable VL, group B, N = 77) were compared to a control group (consistently suppressed viremia since start therapy (<50 copies/mL), N = 79). Residual viremia (detectable viral RNA <50 copies/ml) in the year preceding the first VL above 50 copies/mL (T0) was determined using Roche Cobas-Amplicor v1.5 or CAP-CTM v2.0. Subsequent virologic failure (2 consecutive VLs>500 or 1 VL>1000 copies/mL that was not followed by a VL<50 copies/mL; median follow up 34 months) was assessed.; Results: Significantly more patients in groups A and B had residual viremia in the year preceding T0 compared to controls (50% and 19% vs 3% respectively; p<0.001). Residual viremia was associated with development of low-level viremia or blips (OR 10.9 (95% CI 2.9-40.6)). Subsequent virologic failure was seen more often in group A (3/16) and B (2/77) than in the control group (0/79).; Conclusion: Residual viremia is associated with development of blips and low-level viremia. Virologic failure occurred more often in patients with low-level viremia. These results suggest that low-level viremia results from viral production/replication rather than only assay variation. © 2014 Hofstra et al.
Authors & Co-Authors
Mudrikova, Tania
Netherlands, Utrecht
University Medical Center Utrecht
Otto, Sigrid A.
Netherlands, Utrecht
University Medical Center Utrecht
Tesselaar, Kiki
Netherlands, Utrecht
University Medical Center Utrecht
Nijhuis, Monique M.Oude
Netherlands, Utrecht
University Medical Center Utrecht
Wensing, Annemarie Marie J.
Netherlands, Utrecht
University Medical Center Utrecht
Statistics
Citations: 31
Authors: 5
Affiliations: 1
Identifiers
Doi:
10.1371/journal.pone.0110749
ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Randomised Control Trial