{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:40:37Z","timestamp":1790768437610,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T00:00:00Z","timestamp":1586390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Physicians Against AIDS Research Foundation","award":["FOa2019-0006"],"award-info":[{"award-number":["FOa2019-0006"]}]},{"name":"Gilead Nordic Fellowship","award":["2018004132"],"award-info":[{"award-number":["2018004132"]}]},{"name":"Gilead Nordic Fellowship","award":["ALFSUS- 40103"],"award-info":[{"award-number":["ALFSUS- 40103"]}]},{"name":"Gilead Nordic Fellowship","award":["ALFGBG-717531"],"award-info":[{"award-number":["ALFGBG-717531"]}]},{"name":"Gilead Nordic Fellowship","award":["REGSKANE821541"],"award-info":[{"award-number":["REGSKANE821541"]}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2016-01675"],"award-info":[{"award-number":["2016-01675"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of low levels of human immunodeficiency virus (HIV) RNA (low-level viremia [LLV]) during combination antiretroviral therapy (cART) on clinical outcomes is unclear. We explored the associations between LLV and all-cause mortality, AIDS, and serious non-AIDS events (SNAEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We grouped individuals starting cART 1996\u20132017 (identified from the Swedish InfCare HIV register) as virologic suppression (VS; &amp;lt;50 copies\/mL), LLV (repeated viral load, 50\u2013999 copies\/mL), and nonsuppressed viremia (NSV; \u22651000 copies\/mL). Separately, LLV was subdivided into 50\u2013199 and 200\u2013999 copies\/mL (reflecting different definitions of virologic failure). Proportional-hazard models (including sex, age, pre-ART CD4 count and viral load, country of birth, injection drug use, treatment experience and interruptions, and an interaction term between viremia and time) were fitted for the study outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6956 participants were followed for a median of 5.7 years. At the end of follow-up, 60% were categorized as VS, 9% as LLV, and 31% as NSV. Compared with VS, LLV was associated with increased mortality (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.3\u20133.6). This association was also observed for LLV 50\u2013199 copies\/mL (aHR, 2.2; 95% CI, 1.3\u20133.8), but was not statistically significant for LLV 200\u2013999 copies\/mL (aHR, 2.1; 95% CI, .96\u20134.7). LLV 50\u2013999 copies\/mL was not linked to increased risk of AIDS or SNAEs, but in subanalysis, LLV 200\u2013999 copies\/mL was associated with SNAEs (aHR, 2.0; 95% CI, 1.2\u20133.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this population-based cohort, LLV during cART was associated with adverse clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa413","type":"journal-article","created":{"date-parts":[[2020,4,8]],"date-time":"2020-04-08T15:13:11Z","timestamp":1586358791000},"page":"2079-2086","source":"Crossref","is-referenced-by-count":76,"title":["All-Cause Mortality and Serious Non-AIDS Events in Adults With Low-level Human Immunodeficiency Virus Viremia During Combination Antiretroviral Therapy: Results From a Swedish Nationwide Observational Study"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-9869","authenticated-orcid":false,"given":"Olof","family":"Elvstam","sequence":"first","affiliation":[{"name":"Department of Translational Medicine, Lund University, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Marrone","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Clinical Virology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Medstrand","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Lund University, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl Johan","family":"Treutiger","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases\/Venh\u00e4lsan, South General Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"S\u00f6nnerborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Gissl\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Infectious Diseases, Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Bj\u00f6rkman","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Lund University, Malm\u00f6, Sweden"},{"name":"Department 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