{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:42:12Z","timestamp":1761864132490,"version":"3.40.5"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T00:00:00Z","timestamp":1592956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2020,9]]},"abstract":"Objectives<\/jats:title>The aim of this study was to evaluate the factors that can influence an incomplete viral response (IVR) after acute and early HIV infection (AEHI).<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a retrospective, observational study including patients with AEHI (Fiebig stages I\u2013V) diagnosed between January 2008 and December 2014 at 20 Italian centres. IVR was defined by: (1) viral blip (51\u20131000\u00a0HIV\u20101 RNA copies\/mL after achievement of <\u00a050\u00a0HIV\u20101 RNA\u00a0copies\/mL); (2) virologic failure [>\u00a01000\u00a0copies\/mL after achievement of <\u00a0200\u00a0copies\/mL, or \u2265\u00a0200\u00a0copies\/mL after 24\u00a0weeks on an antiretroviral therapy (ART)]; (3) suboptimal viral response (>\u00a050\u00a0copies\/mL after 48\u00a0weeks on ART or two consecutive HIV\u20101 RNA levels with ascending trend during ART). Cox regression analysis was used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for IVR.<\/jats:p><\/jats:sec>Results<\/jats:title>In all, 263 patients were studied, 227 (86%) males, with a median [interquartile range (IQR)] age of 38 (30\u201346) years. During a median follow\u2010up of 13.0 (5.7\u201331.1) months, 38 (14.4%) had IVR. The presence of central nervous system (CNS) symptoms was linked to a higher risk of IVR (HR = 4.70, 95% CI: 1.56\u201314.17), while a higher CD4\/CD8 cell count ratio (HR = 0.13, 95% CI: 0.03\u20130.51 for each point increase) and first\u2010line ART with three\u2010drug regimens recommended by current guidelines (HR = 0.40, 95% CI: 0.18\u20130.91 compared with other regimens including four or five drugs, older drugs or non\u2010standard backbones) were protective against IVR.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Patients with lower CD4\/CD8 ratio and CNS symptoms could be at a higher risk of IVR after AEHI. The use of recommended ART may be relevant for improving short\u2010term viral efficacy in this group of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12885","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T09:55:45Z","timestamp":1592992545000},"page":"523-535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictors of incomplete viral response and virologic failure in patients with acute and early HIV infection. 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