{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T07:55:31Z","timestamp":1792569331417,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,8,1]],"date-time":"2016-08-01T00:00:00Z","timestamp":1470009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Objectives<\/jats:title>The aim of the study was to investigate whether very low level viraemia (VLLV<\/jats:styled-content>) (20\u201350 HIV<\/jats:styled-content>\u20101 RNA<\/jats:styled-content> copies\/mL<\/jats:styled-content>) was associated with increased risk of virological failure (VF<\/jats:styled-content>) as compared with persistent full suppression (< 20 copies\/mL<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>From the VACH<\/jats:styled-content> Cohort database, we selected those patients who started antiretroviral therapy (ART<\/jats:styled-content>) after January 1997 and who achieved effective viral suppression [two consecutive viral loads (VL<\/jats:styled-content>s) < 50 copies\/mL<\/jats:styled-content>] followed by full suppression (at least one VL<\/jats:styled-content> <20 copies\/mL<\/jats:styled-content>). We carried out survival analyses to investigate whether the occurrence of VLLV<\/jats:styled-content> rather than maintaining full suppression at < 20 copies\/mL<\/jats:styled-content> was associated with virological failure (two consecutive VL<\/jats:styled-content>s > 200 copies\/mL<\/jats:styled-content> or one VL<\/jats:styled-content> > 200 copies\/mL<\/jats:styled-content> followed by a change of ART<\/jats:styled-content> regimen, administrative censoring or loss to follow\u2010up), adjusted for nadir CD<\/jats:styled-content>4 cell count, sex, age, ethnicity, transmission group, type of ART<\/jats:styled-content> and time on effective suppression at < 50 copies\/mL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 21 480 patients who started ART<\/jats:styled-content>, 13 674 (63.7%) achieved effective suppression at < 50 copies\/mL<\/jats:styled-content>, of whom 4289 (31.4%) further achieved full suppression at < 20 copies\/mL<\/jats:styled-content> after May 2009. A total of 2623 patients (61.1%) remained fully suppressed thereafter, while 1666 had one or more episodes of VL<\/jats:styled-content> detection > 20 copies\/mL<\/jats:styled-content> (excluding virological failure). A total of 824 patients had VLLV<\/jats:styled-content> after suppression at < 20 copies\/mL<\/jats:styled-content>. VLLV<\/jats:styled-content> was not associated with virological failure as compared with persistent full suppression [hazard ratio (HR<\/jats:styled-content>) 0.67; 95% confidence interval (CI<\/jats:styled-content>) 0.44\u20131.00], independently of the number of blips recorded (from one to 18).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In our population of HIV<\/jats:styled-content>\u2010infected patients on ART<\/jats:styled-content> who achieved viral suppression at < 20 copies\/mL<\/jats:styled-content>, the risk of virological failure was no different for patients who remained fully suppressed compared with those who experienced subsequent episodes of VLLV<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12413","type":"journal-article","created":{"date-parts":[[2016,8,2]],"date-time":"2016-08-02T16:30:38Z","timestamp":1470155438000},"page":"196-203","source":"Crossref","is-referenced-by-count":22,"title":["Very low level viraemia and risk of virological failure in treated HIV<\/scp>\u20101\u2010infected patients"],"prefix":"10.1111","volume":"18","author":[{"given":"R","family":"Teira","sequence":"first","affiliation":[{"name":"Sierrallana Hospital Torrelavega Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Vidal","sequence":"additional","affiliation":[{"name":"Tarragona University Hospital Joan XXIII Tarragona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Mu\u00f1oz\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Basurto Hospital Bilbao Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Geijo","sequence":"additional","affiliation":[{"name":"Virgen de la Luz Hospital Cuenca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Viciana","sequence":"additional","affiliation":[{"name":"Virgen del Roc\u00edo Hospital Sevilla 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