{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:56:42Z","timestamp":1777453002378,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"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":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pre-cART (combined antiretroviral therapy) plasma viral load &gt;500,000 copies\/ml has been associated with a lower probability of achieving virological suppression, while few data about its role on maintenance of virological suppression are available. In this study we aimed to clarify whether high levels of pre-cART viraemia are associated with virological rebound (VR) after virological suppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>HIV-infected individuals who achieved virological suppression after first-line cART were included. VR was defined as the first of two consecutive viraemia &gt;50 copies\/ml (VR50) or, in an alternative analysis, &gt;200 copies\/ml (VR200). The impact of pre-cART viraemia on the risk of VR was evaluated by survival analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 5,766 patients included, 59.2%, 31.4%, 5.2% and 4.2% had pre-cART viraemia \u2264100,000, 100,001\u2013500,000, 500,001\u20131,000,000 and &gt;1,000,000 copies\/ml, respectively. Patients with pre-cART viraemia levels &gt;1,000,000 copies\/ml had the highest probability of VR (&gt;1,000,000; 500,000\u2013 1,000,000; 100,000\u2013500,000; &lt;100,000 copies\/ml; VR50: 28.4%; 24.3%; 17.6%; 13.8%, P&lt;0.0001; VR200: 14.4%; 11.1%; 7.2%; 7.6%; P=0.009). By Cox multivariable analyses, patients with pre-cART viraemia &gt;500,000 and &gt;1,000,000 copies\/ml showed a significantly higher risk of VR regardless of the VR end point used. No difference in the risk of VR was found between patients with pre-cART viraemia ranging 500,000\u20131,000,000 copies\/ml and those with pre-cART viraemia &gt;1,000,000 copies\/ml, regardless of the VR end point used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-cART plasma viral load levels &gt;500,000 copies\/ml can identify fragile patients with poorer chance of maintaining virological control after an initial response. An effort in defining effective treatment strategies is mandatory for these patients that remain difficult to treat.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3851\/imp3309","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T07:05:53Z","timestamp":1555052753000},"page":"321-331","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Very High Pre-Therapy Viral Load is a Predictor of Virological Rebound in HIV-1-Infected Patients Starting a Modern First-Line Regimen"],"prefix":"10.1177","volume":"24","author":[{"name":"ICONA Foundation Study Group","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Armenia","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Rome \u2018Tor Vergata\u2019, Rome, Italy"},{"name":"Saint Camillus International University of Health Sciences, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico Di","family":"Carlo","sequence":"additional","affiliation":[{"name":"Pediatric Clinical Research Center \u2018Romeo and Erica Invernizzi\u2019, University of Milan, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Cozzi-Lepri","sequence":"additional","affiliation":[{"name":"Institute for Global Health London, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Calcagno","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanni","family":"Borghi","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, University Hospital, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Gori","sequence":"additional","affiliation":[{"name":"Virology Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ada","family":"Bertoli","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Rome \u2018Tor Vergata\u2019, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Gennari","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Polyclinic, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Bellagamba","sequence":"additional","affiliation":[{"name":"Clinical Division of HIV\/AIDS, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, IRCCS San Raffaele Scientific Institute & Vita-Salute University, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Latini","sequence":"additional","affiliation":[{"name":"Unit of Dermatology and Sexually Transmitted Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmela","family":"Pinnetti","sequence":"additional","affiliation":[{"name":"Clinical Division of HIV\/AIDS, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Cicalini","sequence":"additional","affiliation":[{"name":"Clinical Division of HIV\/AIDS, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Saracino","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Bari, Policlinic Hospital, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lapadula","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, \u2018San Gerardo\u2019 Hospital, Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Castelli","sequence":"additional","affiliation":[{"name":"University Department of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona Di","family":"Giambenedetto","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Catholic University of Sacred Heart, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Andreoni","sequence":"additional","affiliation":[{"name":"Clinical Infectious Diseases, University Hospital \u2018Tor Vergata\u2019, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Di Perri","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[{"name":"Clinical Division of HIV\/AIDS, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Mussini","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, University Hospital, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Ceccherini-Silberstein","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Rome \u2018Tor Vergata\u2019, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella D'Arminio","family":"Monforte","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo F","family":"Perno","sequence":"additional","affiliation":[{"name":"Virology Unit, National Institute for Infectious Diseases L. Spallanzani, IRCCS, Rome, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria M","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Rome \u2018Tor Vergata\u2019, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,7,1]]},"reference":[{"key":"bibr1-IMP3309","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61113-7"},{"key":"bibr2-IMP3309","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-251"},{"key":"bibr3-IMP3309","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu834"},{"key":"bibr4-IMP3309","doi-asserted-by":"publisher","DOI":"10.1016\/j.coviro.2016.03.004"},{"key":"bibr5-IMP3309","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-2-199907200-00002"},{"key":"bibr6-IMP3309","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000248351.10383.b7"},{"key":"bibr7-IMP3309","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030265"},{"key":"bibr8-IMP3309","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000422"},{"key":"bibr9-IMP3309","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2531"},{"key":"bibr10-IMP3309","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3197"},{"key":"bibr11-IMP3309","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.24017"},{"key":"bibr12-IMP3309","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx300"},{"key":"bibr13-IMP3309","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09411-4"},{"key":"bibr14-IMP3309","doi-asserted-by":"publisher","DOI":"10.3851\/IMP2636"},{"key":"bibr15-IMP3309","unstructured":"European AIDS Clinical Society (EACS). EACS Guidelines, Version 9.1. 2018. (Accessed 15 February 2019.) Available at http:\/\/www.eacsociety.org\/files\/2018_guidelines-9.1-english.pdf."},{"key":"bibr16-IMP3309","unstructured":"Department of Health and Human Services. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents. 2018. (Accessed 15 February 2019.) Available at https:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/adultandadolescentgl.pdf."},{"key":"bibr17-IMP3309","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200003310-00005"},{"key":"bibr18-IMP3309","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105853"},{"key":"bibr19-IMP3309","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004724"},{"key":"bibr20-IMP3309","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa074609"},{"key":"bibr21-IMP3309","doi-asserted-by":"publisher","DOI":"10.1177\/135965350801300707"},{"key":"bibr22-IMP3309","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu019"},{"key":"bibr23-IMP3309","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03771-14"},{"key":"bibr24-IMP3309","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu020"},{"key":"bibr25-IMP3309","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1093\/jac\/dkv029","volume":"70","author":"Armenia D.","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"bibr26-IMP3309","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000203"},{"key":"bibr27-IMP3309","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12184"},{"key":"bibr28-IMP3309","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00076-14"}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP3309","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3851\/IMP3309","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP3309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:52:46Z","timestamp":1777380766000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3851\/IMP3309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,1]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.3851\/IMP3309"],"URL":"https:\/\/doi.org\/10.3851\/imp3309","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,1]]}}}