{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:58:09Z","timestamp":1790927889328,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Low\u2010level viraemia (LLV) persists in some people living with HIV despite antiretroviral therapy, raising concerns about virologic failure. We assessed the characteristics, management and outcomes of LLV in Greece, where next\u2010generation sequencing, therapeutic drug monitoring and electronic adherence monitoring are unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicentre study included people living with HIV from four Greek clinics who had achieved virological suppression for at least 6\u2009months. LLV was defined as two consecutive HIV\u20101 RNA measurements between 51 and 200 copies\/mL. Patients were followed for 18\u2009months, during which three subsequent viral load measurements were evaluated. Adherence was assessed using patient self\u2010report and documentation in the medical record.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3800 patients, 35 (0.9%) experienced LLV. Median age was 49\u2009years, and 69% were male. Patients were treatment\u2010experienced (median 3.5 ART lines; median duration of viral suppression, 7\u2009years), with 57% receiving high genetic\u2010barrier regimens. Baseline genotypic resistance data were available for 30 of 35 patients (85.7%), and clinically relevant resistance\u2010associated mutations were identified in 6 (20.0%). LLV resolved in 27 of 35 patients (77.1%), persisted in 7 (20.0%) and recurred in 1 (2.9%). No patient developed virologic failure. Presumed causes of LLV were unknown in 18 (51.4%), low adherence in 14 (40.0%) and drug\u2013drug interactions in 3 (8.6%). ART was modified in 17 patients, of whom 13 (76.5%) achieved viral resuppression, most commonly after switching from lower\u2010 to higher\u2010genetic\u2010barrier regimens. One patient with persistent LLV developed lymphoma during follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LLV was uncommon but clinically relevant in this multicentre Greek cohort and frequently resolved following targeted management. Adherence optimization and ART modification, particularly to higher genetic\u2010barrier regimens, were associated with viral resuppression in this cohort. Ongoing monitoring remains essential, especially in settings with limited access to advanced diagnostic tools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70295","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T12:15:43Z","timestamp":1786018543000},"page":"1663-1669","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and management of low\u2010level viraemia in people living with\n                    <scp>HIV<\/scp>\n                    in a resource\u2010limited setting: A multicentre retrospective study in\n                    <scp>Greece<\/scp>"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-2746","authenticated-orcid":false,"given":"Lydia","family":"Leonidou","sequence":"first","affiliation":[{"name":"University of Patras Medical School  Patras Greece"},{"name":"Division of Infectious Diseases University General Hospital of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1734-2109","authenticated-orcid":false,"given":"Giota","family":"Lourida","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Evangelismos General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5404-746X","authenticated-orcid":false,"given":"Konstantinos","family":"Protopapas","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, School of Medicine Attikon University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-7409","authenticated-orcid":false,"given":"Charalampos D.","family":"Moschopoulos","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, School of Medicine Attikon University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1490-6773","authenticated-orcid":false,"given":"Dimitrios","family":"Zoulas","sequence":"additional","affiliation":[{"name":"Blood Bank Department Evangelismos General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7179-2742","authenticated-orcid":false,"given":"Charisis","family":"Totsikas","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Evangelismos General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-872X","authenticated-orcid":false,"given":"Dimitrios","family":"Basoulis","sequence":"additional","affiliation":[{"name":"1st Department of Internal Medicine Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elpida","family":"Mastrogianni","sequence":"additional","affiliation":[{"name":"1st Department of Internal Medicine Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-0528","authenticated-orcid":false,"given":"Apostolos","family":"Beloukas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences University of West Attica  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8900-0212","authenticated-orcid":false,"given":"Maria","family":"Lagadinou","sequence":"additional","affiliation":[{"name":"University of Patras Medical School  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markos","family":"Marangos","sequence":"additional","affiliation":[{"name":"University of Patras Medical School  Patras Greece"},{"name":"Division of Infectious Diseases University General Hospital of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6293-0017","authenticated-orcid":false,"given":"Vasileios","family":"Papastamopoulos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Evangelismos General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-2620","authenticated-orcid":false,"given":"Antonios","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, School of Medicine Attikon University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Psichogiou","sequence":"additional","affiliation":[{"name":"1st Department of Internal Medicine Laiko General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV","author":"Panel on Antiretroviral Guidelines for Adults and Adolescents","year":"2025"},{"key":"e_1_2_11_3_1","volume-title":"Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations","author":"World Health Organization","year":"2016"},{"key":"e_1_2_11_4_1","volume-title":"Major revision version 12.0 of the European AIDS Clinical Society guidelines 2023","author":"Ambrosioni 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