Persistent low-level HIV-1 RNA between 20 and 50 copies/mL in antiretroviral-treated patients: associated factors and virological outcome

The aim of our study was to identify factors associated with persistent low-level viraemia (LLV) in HIV-infected patients under suppressive antiretroviral therapy and to assess the virological outcome of these patients. LLV was defined as at least two HIV-1 RNA values between 20 and 50 copies/mL dur...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2012-09, Vol.67 (9), p.2231-2235
Main Authors: Charpentier, Charlotte, Landman, Roland, Laouénan, Cédric, Joly, Véronique, Hamet, Gwenn, Damond, Florence, Brun-Vézinet, Françoise, Mentré, France, Descamps, Diane, Yeni, Patrick
Format: Article
Language:English
Subjects:
Adult
Anti-Retroviral Agents - administration & dosage
Antiretroviral drugs
antiretroviral therapy
Chemotherapy
Drug therapy
Female
HIV
HIV Infections - drug therapy
HIV Infections - virology
HIV-1 - isolation & purification
Human immunodeficiency virus
Human immunodeficiency virus 1
Humans
Longitudinal Studies
Male
Middle Aged
Plasma - virology
Replication
Ribonucleic acid
RNA
RNA, Viral - immunology
Treatment Outcome
Viral Load
Viremia
Virology
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Summary:The aim of our study was to identify factors associated with persistent low-level viraemia (LLV) in HIV-infected patients under suppressive antiretroviral therapy and to assess the virological outcome of these patients. LLV was defined as at least two HIV-1 RNA values between 20 and 50 copies/mL during 1 year of follow-up. We compared patients with all values 50 copies/mL)/(number of HIV-1 RNA determinations) before study inclusion. Among the 656 patients included, 5.8% were in group LLV+. CDC stage B/C at study inclusion and a higher blip ratio before the study period were the only factors independently associated with LLV. During the 1 year follow-up, the proportion of patients experiencing virological failure was not different between the LLV- and LLV+ groups, and 40% of patients shifted from LLV+ to LLV- status. LLV was infrequent in our series and the follow-up did not evidence a higher rate of virological failure than in fully suppressed patients. LLV seems to be a transient phenomenon that might be driven by residual ongoing viral replication and/or viral release and/or accuracy of viral load assay at lower values.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dks191