Determinants of residual viraemia during combination HIV treatment: Impacts of baseline HIV RNA levels and treatment choice.


OBJECTIVES:Effective HIV therapy reflects suppression of plasma HIV RNA levels below assay detection thresholds, although lower levels of "residual viraemia" have also been demonstrated over extended periods of effective antiretroviral treatment. Here we examine the determinants of HIV RNA suppression below the standard assay threshold (40 HIV-1 RNA copies/mL) as well as factors associated with detectable HIV RNA below this reported detection limit. METHODS:Between 2007 and 2010, 11 575 consecutive viral load (VL) tests were obtained from 1540 patients, including 356 on effective antiretroviral therapy followed since initiation (1996-2001: n = 165; 2002-2009: n = 191). Analyses modelled the probability of an undetectable VL given successful suppression to < 200 copies/mL, and the probability of residual viraemia given an undetectable result. RESULTS:Detectable HIV RNA amplification was demonstrated in 20% of samples with a VL result < 40 copies/mL. Longitudinal analyses from 356 patients revealed that the likelihood of achieving results < 40 copies/mL was increased with current nonnucleoside reverse transcriptase inhibitor (NNRTI) therapy [odds ratio (OR) 2.0; P < 0.05] and reduced with prior virological rebound (OR 0.5; P < 0.05). In contrast, the presence of detectable HIV RNA < 40 copies/mL was strongly associated with pretreatment HIV RNA levels among those on current protease inhibitor (PI) treatment (OR 1.5 per log10 copies/mL increase; P = 0.02) as well as those on NNRTIs (OR 1.7; P = 0.002). CONCLUSIONS:While HIV treatment history was associated with plasma HIV RNA levels below the detection limit, residual viraemia results were dominantly determined by pretreatment VL. These findings support the concept of a stable, long-lived reservoir of latently infected cells as a source of residual viraemia despite effective HIV treatment.




HIV medicine


McKinnon E,Castley A,Payne L,Pummer S,Nolan D




Has Abstract


2016-08-01 00:00:00












  • Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney.

    abstract:OBJECTIVES:Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics. METHODS:Service providers were surveyed immediately afte...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Conway DP,Guy R,McNulty A,Couldwell DL,Davies SC,Smith DE,Keen P,Cunningham P,Holt M,Sydney Rapid HIV Test Study.

    更新日期:2015-05-01 00:00:00

  • Late presentation of HIV infection: a consensus definition.

    abstract:OBJECTIVES:Across Europe, almost a third of individuals infected with HIV do not enter health care until late in the course of their infection. Surveillance to identify the extent to which late presentation occurs remains inadequate across Europe and is further complicated by the lack of a common clinical definition of...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Antinori A,Coenen T,Costagiola D,Dedes N,Ellefson M,Gatell J,Girardi E,Johnson M,Kirk O,Lundgren J,Mocroft A,D'Arminio Monforte A,Phillips A,Raben D,Rockstroh JK,Sabin C,Sönnerborg A,De Wolf F,European Late Presenter

    更新日期:2011-01-01 00:00:00

  • Valproic acid in association with highly active antiretroviral therapy for reducing systemic HIV-1 reservoirs: results from a multicentre randomized clinical study.

    abstract:OBJECTIVES:Conflicting results have been reported regarding the ability of valproic acid (VPA) to reduce the size of HIV reservoirs in patients receiving suppressive highly active antiretroviral therapy (HAART). In a randomized multicentre, cross-over study, we assessed whether adding VPA to stable HAART could potentia...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Routy JP,Tremblay CL,Angel JB,Trottier B,Rouleau D,Baril JG,Harris M,Trottier S,Singer J,Chomont N,Sékaly RP,Boulassel MR

    更新日期:2012-05-01 00:00:00

  • Impact of immune interventions on proviral HIV-1 DNA decay in patients receiving highly active antiretroviral therapy.

    abstract:OBJECTIVE:To measure the evolution of proviral HIV-1 DNA levels in patients receiving highly active antiretroviral therapy (HAART) compared to those treated with HAART plus interleukin-2 (IL-2) and hydroxyurea. DESIGN:Prospective randomised trial. METHODS:Twenty-two HIV-1 infected patients were randomly assigned to a...

    journal_title:HIV medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Lafeuillade A,Poggi C,Chadapaud S,Hittinger G,Khiri H,Halfon P

    更新日期:2001-07-01 00:00:00

  • HIV/hepatitis C virus and HIV/hepatitis B virus coinfections protect against antiretroviral-related hyperlipidaemia.

    abstract:INTRODUCTION:Hyperlipidaemia is a recognized complication of HIV antiretroviral therapy. The interactions among HIV, viral hepatitis, antiretroviral therapies and lipids are poorly understood. METHODS:Ontario HIV Treatment Network Cohort Study participants with at least one lipid level after highly active antiretrovir...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Diong C,Raboud J,Li M,Cooper C,Ontario HIV Treatment Network Cohort Study Team.

    更新日期:2011-08-01 00:00:00

  • A global survey of HIV-positive people's attitudes towards cure research.

    abstract:OBJECTIVES:Involvement of people living with HIV (PLHIV) in the design of HIV cure studies is important, given the potential risks to participants. We present results of an international survey of PLHIV to define these issues and inform cure research. METHODS:PLHIV were recruited in June-November 2014 through HIV webs...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Simmons R,Kall M,Collins S,Cairns G,Taylor S,Nelson M,Fidler S,Porter K,Fox J,Collaborative HIV Eradication of viral Reservoirs (CHERUB) Survey collaboration.

    更新日期:2017-02-01 00:00:00

  • Rapid initiation of antiretroviral therapy at HIV diagnosis: definition, process, knowledge gaps.

    abstract::Initiating antiretroviral therapy (ART) as early as the day of HIV diagnosis is a strategy of increasing global interest to control the HIV epidemic and optimize the health of people living with HIV (PLWH). No detrimental effects of rapid-start ART have been identified in randomized controlled trials undertaken in low...

    journal_title:HIV medicine

    pub_type: 杂志文章,评审


    authors: Boyd MA,Boffito M,Castagna A,Estrada V

    更新日期:2019-03-01 00:00:00

  • GENOPHAR: a randomized study of plasma drug measurements in association with genotypic resistance testing and expert advice to optimize therapy in patients failing antiretroviral therapy.

    abstract:OBJECTIVES:To evaluate the benefits of therapeutic drug monitoring (TDM) in association with genotypic resistance testing and expert advice to optimize therapy in multiexperienced patients infected with HIV-1. METHODS:Patients with a viral load>1000 HIV-1 RNA copies/mL and an unchanged antiretroviral therapy regimen o...

    journal_title:HIV medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Bossi P,Peytavin G,Ait-Mohand H,Delaugerre C,Ktorza N,Paris L,Bonmarchand M,Cacace R,David DJ,Simon A,Lamotte C,Marcelin AG,Calvez V,Bricaire F,Costagliola D,Katlama C

    更新日期:2004-09-01 00:00:00

  • Financial stress is associated with reduced treatment adherence in HIV-infected adults in a resource-rich setting.

    abstract:OBJECTIVES:Financial stress has been identified as a barrier to antiretroviral adherence, but only in resource- limited settings. Almost half of HIV-infected Australian adults earn no regular income and, despite highly subsidised antiretroviral therapy and universal health care, 3% of HIV-infected Australians cease ant...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: McAllister J,Beardsworth G,Lavie E,MacRae K,Carr A

    更新日期:2013-02-01 00:00:00

  • HIV and hepatitis C virus coinfection in Canada: challenges and opportunities for reducing preventable morbidity and mortality.

    abstract:OBJECTIVES:Hepatitis C virus (HCV) has emerged as an important health problem in the era of effective HIV treatment. However, very few data exist on the health status and disease burden of HIV/HCV-coinfected Canadians. METHODS:HIV/HCV-coinfected patients were enrolled prospectively in a multicentre cohort from 16 cent...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究


    authors: Klein MB,Rollet KC,Saeed S,Cox J,Potter M,Cohen J,Conway B,Cooper C,Côté P,Gill J,Haase D,Haider S,Hull M,Moodie E,Montaner J,Pick N,Rachlis A,Rouleau D,Sandre R,Tyndall M,Walmsley S,Canadian HIV-HCV Cohort Inve

    更新日期:2013-01-01 00:00:00

  • Therapeutic drug monitoring of atazanavir/ritonavir in pregnancy.

    abstract:OBJECTIVES:Pregnant women experience physiological changes during pregnancy that can have a significant impact on antiretroviral pharmacokinetics. Ensuring optimal plasma concentrations of antiretrovirals is essential for maternal health and to minimize the risk of vertical transmission. Here we describe atazanavir/rit...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Else LJ,Jackson V,Brennan M,Back DJ,Khoo SH,Coulter-Smith S,Lambert JS

    更新日期:2014-11-01 00:00:00

  • Blood Epstein-Barr virus DNA load and risk of progression to AIDS-related systemic B lymphoma.

    abstract:BACKGROUND:AIDS-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the combined antiretroviral therapy (cART) era. Although most ARLs are associated with the Epstein-Barr virus (EBV), whether patients with high EBV burden are more at risk of developing ARL is unknown. This study investigated the re...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Leruez-Ville M,Seng R,Morand P,Boufassa F,Boue F,Deveau C,Rouzioux C,Goujard C,Seigneurin JM,Meyer L

    更新日期:2012-09-01 00:00:00

  • Risk of non-AIDS-defining events among HIV-infected patients not yet on antiretroviral therapy.

    abstract:OBJECTIVES:Certain non-AIDS-related diseases have been associated with immunodeficiency and HIV RNA levels in HIV-infected patients on combination antiretroviral therapy (cART). We aimed to investigate these associations in patients not yet on cART, when potential antiretroviral-drug-related effects are absent and vari...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Zhang S,van Sighem A,Kesselring A,Gras L,Prins JM,Hassink E,Kauffmann R,Richter C,de Wolf F,Reiss P,ATHENA national observational HIV cohort study.

    更新日期:2015-05-01 00:00:00

  • Clinical outcomes of first antiretroviral regimen in HIV/hepatitis C virus co-infection.

    abstract:OBJECTIVES:Despite the benefits of HAART, initiation of antiretroviral therapy in HIV-HCV co-infected patients is often delayed as a consequence of patient and physician concern pertaining to liver toxicity. It is unclear whether this is justified. METHODS:We retrospectively evaluated treatment duration and outcome in...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Cooper CL,Breau C,Laroche A,Lee C,Garber G

    更新日期:2006-01-01 00:00:00

  • Mortality in perinatally HIV-infected young people in England following transition to adult care: an HIV Young Persons Network (HYPNet) audit.

    abstract:OBJECTIVES:Mortality in young people with perinatally acquired HIV infection (PHIV) following transfer to adult care has not been characterized in the UK. We conducted a multicentre audit to establish the number of deaths and associated factors. METHODS:Fourteen adult clinics caring for infected young people reported ...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究


    authors: Fish R,Judd A,Jungmann E,O'Leary C,Foster C,HIV Young Persons Network (HYPNet).

    更新日期:2014-04-01 00:00:00

  • Diagnosing HIV infection in patients presenting with glandular fever-like illness in primary care: are we missing primary HIV infection?

    abstract:OBJECTIVES:The aim of the study was to examine the prevalence of HIV infection in patients presenting in primary care with glandular fever (GF)-like illness. METHODS:Samples from primary care submitted for a GF screen between April 2009 and June 2010 were identified. Samples without an HIV request were anonymized and ...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Hsu DT,Ruf M,O'Shea S,Costelloe S,Peck J,Tong CY

    更新日期:2013-01-01 00:00:00

  • Human leucocyte antigen (HLA)-DQB1*03:02 and HLA-A*02:01 have opposite patterns in their effects on susceptibility to HIV infection.

    abstract:OBJECTIVES:The objective of this study was to seek correlates of immune protection in HIV infection. We sought to elucidate the association between the presence of human leucocyte antigen (HLA) alleles, as well as killer immunoglobulin receptor (KIR) genotypes, and the susceptibility to HIV infection in a Spanish cohor...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Rallón N,Restrepo C,Vicario JL,Del Romero J,Rodríguez C,García-Samaniego J,García M,Cabello A,Górgolas M,Benito JM

    更新日期:2017-09-01 00:00:00

  • Liver-related deaths in HIV-infected patients between 1995 and 2005 in the French GERMIVIC Joint Study Group Network (Mortavic 2005 study in collaboration with the Mortalité 2005 survey, ANRS EN19).

    abstract:BACKGROUND:More than 10 years after the introduction of combination antiretroviral therapy (cART), we examined the trend in the proportion of deaths caused by end-stage liver disease (ESLD) in HIV-infected adults in France between 1995 and 2005. DESIGN AND METHODS:In 2005, 34 departments prospectively recorded all dea...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究


    authors: Rosenthal E,Salmon-Céron D,Lewden C,Bouteloup V,Pialoux G,Bonnet F,Karmochkine M,May T,François M,Burty C,Jougla E,Costagliola D,Morlat P,Chêne G,Cacoub P,Mortavic\/Mortalité 2005 Study Group.

    更新日期:2009-05-01 00:00:00

  • Has testing been normalized? An analysis of changes in barriers to HIV testing among men who have sex with men between 2000 and 2010 in Scotland, UK.

    abstract:OBJECTIVES:This paper examines changes in barriers to HIV testing amongst gay men. We compared data collected in 2000 and 2010 to assess changes in HIV testing behaviours, in community-level perceptions of barriers to HIV testing, and in the relative contributions of barrier measures. METHODS:Cross-sectional surveys w...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Flowers P,Knussen C,Li J,McDaid L

    更新日期:2013-02-01 00:00:00

  • Regulation of adiponectin in adipocytes upon exposure to HIV-1.

    abstract:OBJECTIVES:Adipose dysregulation, dyslipidemia, and insulin resistance are hallmarks of HIV-related lipodystrophy. The precise mechanisms behind these disturbances are unknown. In HIV-infected patients, we previously demonstrated a strong relationship between lipodystrophy and levels of adiponectin, an adipose peptide ...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Sankalé JL,Tong Q,Hadigan CM,Tan G,Grinspoon SK,Kanki PJ,Hotamisligil GS

    更新日期:2006-05-01 00:00:00

  • A systematic review of risk of HIV transmission through biting or spitting: implications for policy.

    abstract:OBJECTIVES:The perceived threat of HIV transmission through spitting and biting is evidenced by the increasing use of "spit hoods" by Police Forces in the UK. In addition, a draft parliamentary bill has called for increased penalties for assaults on emergency workers, citing the risk of communicable disease transmissio...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Cresswell FV,Ellis J,Hartley J,Sabin CA,Orkin C,Churchill DR

    更新日期:2018-04-23 00:00:00

  • Changes in elevated cholesterol in the era of tenofovir in South Africa: risk factors, clinical management and outcomes.

    abstract:OBJECTIVES:Antiretroviral therapy (ART) has been associated with unfavourable lipid profile changes and increased risk of cardiovascular disease (CVD). With a growing population on ART in South Africa, there has been concern about the increase in noncommunicable diseases such as CVD. We determined risk factors associat...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Jamieson L,Evans D,Brennan AT,Moyo F,Spencer D,Mahomed K,Maskew M,Long L,Rosen S,Fox MP

    更新日期:2017-09-01 00:00:00

  • Raltegravir-emtricitabine-tenofovir as HIV nonoccupational post-exposure prophylaxis in men who have sex with men: safety, tolerability and adherence.

    abstract:OBJECTIVES:Three-drug nonoccupational post-exposure prophylaxis (NPEP) typically includes co-formulated emtricitabine-tenofovir (FTC-TDF) and a protease inhibitor. However, protease inhibitors can cause significant toxicities, can interact with prescribed and illicit drugs, and work late in the viral cycle. Agents that...

    journal_title:HIV medicine

    pub_type: 临床试验,杂志文章,多中心研究


    authors: McAllister J,Read P,McNulty A,Tong WW,Ingersoll A,Carr A

    更新日期:2014-01-01 00:00:00

  • The role of brain biopsy in the clinical management of HIV-related focal brain lesions.

    abstract:OBJECTIVES:Up to 20% of HIV-related focal brain lesion (FBL) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with FBL, the proportion of diagnoses confirmed...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Acosta MC,Kundro M,Viloria G,Peressín Paz A,Morello F,Latorre F,Seoane E,Toibaro J,Losso M

    更新日期:2018-11-01 00:00:00

  • Polypharmacy and potential drug-drug interactions for people with HIV in the UK from the Climate-HIV database.

    abstract:OBJECTIVES:People with HIV (PWHIV) are likely to need therapies for comorbidities as they age. We assessed risk of drug-drug interactions (DDIs) in PWHIV. METHODS:The Climate-HIV electronic recording system was used to cross-sectionally analyse records from PWHIV aged ≥ 18 years attending four UK HIV units with a curr...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Okoli C,Schwenk A,Radford M,Myland M,Taylor S,Darley A,Barnes J,Fox A,Grimson F,Reeves I,Munshi S,Croucher A,Boxall N,Benn P,Paice A,van Wyk J,Khoo S

    更新日期:2020-09-01 00:00:00

  • Universal test and treat in relation to HIV disease progression: results from a stepped-wedge trial in Eswatini.

    abstract:OBJECTIVES:Universal test and treat (UTT) is recommended for people living with HIV (PLHIV) to reduce morbidity/mortality and minimize transmission. However, concerns exist that this strategy may lead to more crowded hospitals, longer wait times and poorer service, adversely impacting health outcomes for clients with s...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Boeke CE,Khan S,Walsh F,Hettema A,Lejeune C,Spiegelman D,Okello V,Harwell J,Mazibuko S,Bärnighausen T

    更新日期:2021-01-01 00:00:00

  • Potential lung cancer screening outcomes using different age and smoking thresholds in the ANRS-CO4 French Hospital Database on HIV cohort.

    abstract:OBJECTIVES:In most lung screening programmes, only subjects ≥ 55 years old and smoking ≥ 30 pack-years are eligible to undergo chest low-dose computed tomography. Whether the same criteria should apply to people living with HIV (PLHIV) is uncertain, given the increased lung cancer risks associated with immunodeficiency...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Makinson A,Tron L,Grabar S,Milleron B,Reynes J,Le Moing V,Morquin D,Lert F,Costagliola D,Guiguet M

    更新日期:2020-03-01 00:00:00

  • Trends in uptake of recently approved antiretrovirals within a national healthcare system.

    abstract:OBJECTIVE:The aim of the study was to describe Veterans Healthcare Administration (VHA) system-wide uptake of three HIV protease inhibitors: atazanavir, darunavir and tipranavir. METHODS:This retrospective cohort study evaluated VHA uptake of three target antiretrovirals and lopinavir/ritonavir in each complete 90-day...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Belperio PS,Mole LA,Boothroyd DB,Backus LI

    更新日期:2010-03-01 00:00:00

  • Correction of facial lipoatrophy using autologous fat transplants in HIV-infected adolescents.

    abstract:OBJECTIVES:Antiretroviral therapy has dramatically improved the survival of HIV-infected children. Nevertheless, side effects comparable to those found in adults have been encountered, such as facial lipoatrophy, which can have a negative impact on the self-esteem of otherwise healthy adolescents. Cosmetic surgical pro...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Dollfus C,Blanche S,Trocme N,Funck-Brentano I,Bonnet F,Levan P

    更新日期:2009-05-01 00:00:00

  • Pancreatic exocrine insufficiency in HIV-positive patients.

    abstract:OBJECTIVES:We describe the management of a cohort of eight HIV-positive patients on antiretroviral medication with evidence of pancreatic insufficiency consisting of chronic diarrhoea and a low faecal elastase measurement. PATIENTS AND METHODS:Twenty-two patients with chronic diarrhoea for whom a faecal elastase measu...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Price DA,Schmid ML,Ong EL,Adjukeiwicz KM,Peaston B,Snow MH

    更新日期:2005-01-01 00:00:00