{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:19:18Z","timestamp":1790263158837,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,5,1]],"date-time":"2015-05-01T00:00:00Z","timestamp":1430438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low-level viraemia (LLV) occurs in 20\u201340% of patients achieving viral suppression with antiretroviral therapy (ART). The risk of virological failure (VF: confirmed HIV RNA &gt;200 copies\/ml) in these patients is still a matter of debate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective cohort study in HIV-infected adults attending the HIV clinic of a tertiary care hospital in Spain. Patients with HIV RNA &lt;25 copies\/ml and stable ART for at least 6 months presenting LLV (defined as HIV RNA between 25\u20131,000 copies\/ml) from January 2011 to January 2013 were included and followed until VF or end of follow-up in June 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 300 out of 1,733 (17.3%) patients with undetectable viraemia for 4.2 years showed LLV: 25\u201350 copies\/ml in 167 (55.7%) patients, 51\u2013200 copies\/ml in 111 (37%) and 201\u20131,000 copies\/ml in 22 (7.3%) cases. After a median follow-up of 2.6 years, 23 (7.7%) patients presented VF. No patient with a single or multiple unconfirmed LLV went on to develop VF. HIV RNA &gt;200 copies\/ml (HR 59.6; 95% CI 15.7, 227), ritonavir-boosted protease inhibtor (PI\/r)-based dual therapy (HR 10.2; 95% CI 2.1, 49.8) and PI\/r monotherapy (HR 7.9; 95% CI 1.4, 43.3) were associated with VF. Persistent LLV, defined as HIV RNA &lt;200 copies\/ml in at least three consecutive samples, for at least 12 weeks, was detected in 27 (1.6%) patients and 14 (51.9%) of those evolved to VF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly one-fifth of patients on suppressive ART showed LLV and 8% of them developed VF. HIV RNA &gt;200 copies\/ml was the strongest predictor of VF. Over half of patients with persistent viraemia &lt;200 copies\/ml showed VF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp3023","type":"journal-article","created":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T09:40:28Z","timestamp":1452591628000},"page":"345-352","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of Low-Level Viraemia on Virological Failure in HIV-1-Infected Patients with Stable Antiretroviral Treatment"],"prefix":"10.1177","volume":"21","author":[{"given":"Jordi","family":"Navarro","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estrella","family":"Caballero","sequence":"additional","affiliation":[{"name":"Microbiology and Parasitology Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Curran","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin","family":"Burgos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inma","family":"Oca\u00f1a","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicen\u00e7","family":"Falc\u00f3","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariadna","family":"Torrella","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Ribera","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Crespo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona, Barcelona, Spain"},{"name":"Vall d'Hebron Research Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,5,1]]},"reference":[{"key":"bibr1-IMP3023","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2014.02.018"},{"key":"bibr2-IMP3023","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. (Accessed December 2015.) Available at http:\/\/aidsinfo.nih.gov\/ContentFiles\/AdultandAdolescentGL.pdf."},{"key":"bibr3-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000118"},{"key":"bibr4-IMP3023","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.17.4.19757"},{"key":"bibr5-IMP3023","doi-asserted-by":"publisher","DOI":"10.1310\/hct1002-116"},{"key":"bibr6-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm516"},{"key":"bibr7-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200209270-00017"},{"key":"bibr8-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200210180-00008"},{"key":"bibr9-IMP3023","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.2.171"},{"key":"bibr10-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200308150-00003"},{"key":"bibr11-IMP3023","doi-asserted-by":"publisher","DOI":"10.1086\/315260"},{"key":"bibr12-IMP3023","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.7.817"},{"key":"bibr13-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200205030-00010"},{"key":"bibr14-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu019"},{"key":"bibr15-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200404300-00005"},{"key":"bibr16-IMP3023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2006.00403.x"},{"key":"bibr17-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit529"},{"key":"bibr18-IMP3023","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050065"},{"key":"bibr19-IMP3023","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2008.02.007"},{"key":"bibr20-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu020"},{"key":"bibr21-IMP3023","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000216381.37679.69"},{"key":"bibr22-IMP3023","first-page":"642","volume":"22","author":"Wensing A.M.","year":"2014","journal-title":"Top Antivir Med"},{"key":"bibr23-IMP3023","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1177\/135965350200700404","volume":"7","author":"Mira J.A.","year":"2002","journal-title":"Antivir Ther"},{"key":"bibr24-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir936"},{"key":"bibr25-IMP3023","unstructured":"European AIDS Clinical Society (EACS) guidelines for the clinical management and treatment of HIV-infected adults. Version 7.02. (Updated June 2014. Accessed October 2015.) Available from www.eacsociety.org\/files\/guidelines-7.1-english.pdf."},{"key":"bibr26-IMP3023","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.17.4.19788"},{"key":"bibr27-IMP3023","unstructured":"Paton N., Stohr W., Arenas-Pinto A. Randomised controlled trial of a PI monotherapy switch strategy for long-term HIV management.\n                      21st Conference on Retroviruses and Opportunistic Infections\n                      . 22\u201325 February 2014, Boston, MA, USA. Abstract 550LB."},{"key":"bibr28-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks227"},{"key":"bibr29-IMP3023","unstructured":"Ribaudo H., Lennox J., Currier J. Virologic failure endpoint definition in clinical trials: is using HIV-1 RNA threshold <200 copies\/ml better than <50 copies\/ml? An analysis of ACTG studies.\n                      16th Conference on Retroviruses and Opportunistic Infections\n                      . 8\u201311 February 2009, Montreal, Canada. Abstract 580."},{"key":"bibr30-IMP3023","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir353"},{"key":"bibr31-IMP3023","unstructured":"Eron J.J., Cooper D.A., Steigbigel R.T. Sustained antiretroviral effect of raltegravir at week 156 in the BENCHMRK studies, and exploratory analysis of late outcomes based on early virologic responses.\n                      17th Conference on Retroviruses and Opportunistic Infections\n                      . 16\u201319 February 2010, San Francisco, CA, USA. Abstract 515."}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP3023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP3023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:52:33Z","timestamp":1777380753000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3851\/IMP3023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,1]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.3851\/IMP3023"],"URL":"https:\/\/doi.org\/10.3851\/imp3023","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,1]]}}}