{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:42:13Z","timestamp":1792237333464,"version":"4.4.0"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"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":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Low-level viraemia (LLV) in people living with HIV (PLWH) remains a clinical challenge, associated with increased risk of virological failure, immune dysregulation, and chronic inflammation. Bictegravir\/emtricitabine\/tenofovir alafenamide is a single-tablet regimen with a high genetic barrier to resistance, but real-world outcomes after switching in PLWH with LLV remain insufficiently characterized. This study aimed to describe virological, immunological, metabolic, and safety outcomes after switching to bictegravir\/emtricitabine\/tenofovir alafenamide in PLWH with documented LLV over 96 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, multicentre study was conducted across 12 Spanish healthcare centres. PLWH aged \u226518 years with a documented qualifying LLV episode before switch (two consecutive HIV-1 RNA measurements between 50 and 400 copies\/mL) who switched to bictegravir\/emtricitabine\/tenofovir alafenamide were included (N = 123). Outcomes included virological suppression (&lt;50 copies\/mL), residual LLV, CD4+\/CD8+ dynamics, metabolic changes, and safety. Analyses were descriptive, used observed denominators, and included a non-completer=failure sensitivity analysis for virological suppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among participants (median age: 52 years, 80.5% male; median time since HIV diagnosis: 30 years), observed LLV decreased to 11.4% (13\/114 patients) at 96 weeks after switching to bictegravir\/emtricitabine\/tenofovir alafenamide (p&lt;0.001). In the non-completer=failure sensitivity analysis, virological suppression at week 96 was 82.1% (101\/123). At week 96, all detectable HIV-1 RNA values were 55-272 copies\/mL; 3\/13 patients had LLV at all available 24-, 48-, and 96-week visits. CD4+\/CD8+ ratios remained stable, with a significant reduction in CD8+ T cell counts in patients \u226550 years. Biochemical markers were broadly stable, but weight\/BMI increases and a shift toward overweight were observed and warrant monitoring. No treatment discontinuations due to adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single-arm retrospective cohort, switching to bictegravir\/emtricitabine\/tenofovir alafenamide was associated with a high observed proportion of virological suppression, immune stability, and favourable tolerability over 96 weeks; however, causal effectiveness cannot be inferred. These findings support further comparative prospective evaluation of bictegravir\/emtricitabine\/tenofovir alafenamide for LLV management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261482031","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:46:32Z","timestamp":1792010792000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of Switching to Bictegravir\/Emtricitabine\/Tenofovir Alafenamide in People Living With HIV and Low-Level Viraemia"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7073-5211","authenticated-orcid":false,"given":"Ignacio","family":"de los Santos","sequence":"first","affiliation":[{"name":"Hospital Universitario La Princesa"},{"name":"CIBERINFEC Instituto de Salud Carlos III"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Pousada","sequence":"additional","affiliation":[{"name":"Hospital \u00c1lvaro Cunqueiro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Galera","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen de la Arrixaca"},{"name":"Instituto Murciano de Investigaci\u00f3n Biosanitaria Pascual Parrilla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Due\u00f1as","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valladolid"},{"name":"Valladolid Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Buz\u00f3n","sequence":"additional","affiliation":[{"name":"Hospital de Burgos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Sanz","sequence":"additional","affiliation":[{"name":"Hospital Pr\u00edncipe de Asturias"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"Complejo Asistencial de Zamora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda \u00c1ngeles","family":"Garcinu\u00f1o","sequence":"additional","affiliation":[{"name":"Complejo Asistencial de \u00c1vila"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Galindo","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico Universitario de Valencia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucio","family":"Garc\u00eda-Fraile","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Princesa"},{"name":"CIBERINFEC Instituto de Salud Carlos III"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Pedrero-Tom\u00e9","sequence":"additional","affiliation":[{"name":"Hospital Universitario Infanta Leonor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Troya","sequence":"additional","affiliation":[{"name":"Hospital Universitario Infanta Leonor"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.virol.2024.110362"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13250"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.2174\/1570162x20666220216102943"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.2174\/1570162x13666150407142539"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02611-1"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)00877-2"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21167"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu020"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13265"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.7954"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2013.10.001"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-021-00547-0"},{"key":"e_1_3_8_14_2","unstructured":"HHS panel on Antiretroviral Guidelines for Adults and Adolescents. 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