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












  • Pulmonary function in an international sample of HIV-positive, treatment-naïve adults with CD4 counts > 500 cells/μL: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.

    abstract:OBJECTIVES:The aim of the study was to describe the prevalence and correlates of chronic obstructive pulmonary disease (COPD) in a multicentre international cohort of persons living with HIV (PLWH). METHODS:We performed a cross-sectional analysis of adult PLWH, naïve to HIV treatment, with baseline CD4 cell count > 50...

    journal_title:HIV medicine

    pub_type: 杂志文章,随机对照试验


    authors: Kunisaki KM,Niewoehner DE,Collins G,Nixon DE,Tedaldi E,Akolo C,Kityo C,Klinker H,La Rosa A,Connett JE,International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) START Study Group.

    更新日期:2015-04-01 00:00:00

  • Lopinavir and atazanavir in pregnancy: comparable infant outcomes, virological efficacies and preterm delivery rates.

    abstract:OBJECTIVES:The aim of the study was to identify differences in infant outcomes, virological efficacy, and preterm delivery (PTD) outcome between women exposed to lopinavir/ritonavir (LPV/r) and those exposed to atazanavir/ritonavir (ATV/r). METHODS:A retrospective case note review was carried out. The case notes of 49...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Perry ME,Taylor GP,Sabin CA,Conway K,Flanagan S,Dwyer E,Stevenson J,Mulka L,McKendry A,Williams E,Barbour A,Dermont S,Roedling S,Shah R,Anderson J,Rodgers M,Wood C,Sarner L,Hay P,Hawkins D,deRuiter A

    更新日期:2016-01-01 00:00:00

  • Sexualized drug use ('chemsex') and high-risk sexual behaviours in HIV-positive men who have sex with men.

    abstract:OBJECTIVES:The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use ("chemsex") and injecting drug use ("slamsex") may play a part in this. We aimed to characterize HIV-positive MSM engaging in c...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Pufall EL,Kall M,Shahmanesh M,Nardone A,Gilson R,Delpech V,Ward H,Positive Voices study group.

    更新日期:2018-04-01 00:00:00

  • Quantifying the drivers of HIV transmission and prevention in men who have sex with men: a population model-based analysis in Switzerland.

    abstract:OBJECTIVES:Despite the huge success of antiretroviral therapy (ART), there is an ongoing HIV epidemic among men who have sex with men (MSM) in resource-rich countries. Understanding the driving factors underlying this process is important for curbing the epidemic. METHODS:We simulated the HIV epidemic in MSM in Switze...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Kusejko K,Marzel A,Hampel B,Bachmann N,Nguyen H,Fehr J,Braun DL,Battegay M,Bernasconi E,Calmy A,Cavassini M,Hoffmann M,Böni J,Yerly S,Klimkait T,Perreau M,Rauch A,Günthard HF,Kouyos RD,Swiss HIV Cohort Study.

    更新日期:2018-11-01 00:00:00

  • Lamivudine-based maintenance antiretroviral therapies in patients living with HIV-1 with suppressed HIV RNA: derivation of a predictive score for virological failure.

    abstract:OBJECTIVES:Two-drug antiretroviral regimens based on lamivudine (3TC) plus either a protease inhibitor (PI) or dolutegravir (DTG) are becoming increasingly popular in switch strategies. Our goal was to derive a predictive score for virological failure (VF). METHODS:We retrospectively analysed data for a cohort of 587 ...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Borghetti A,Moschese D,Cingolani A,Baldin G,Speziale D,Ciccullo A,Lombardi F,Emiliozzi A,Belmonti S,Antinori A,Cauda R,Di Giambenedetto S

    更新日期:2019-10-01 00:00:00

  • The changing demographics of new HIV diagnoses at a London centre from 1994 to 2000.

    abstract:OBJECTIVE:To document the demographic changes in new HIV diagnoses at the Royal Free Hospital, London, UK, between 1994 and 2000. DESIGN:Retrospective case note review. METHODS:Data were extracted from the Royal Free HIV database identifying new diagnoses for 1994, 1997 and 2000. All case notes were reviewed and pati...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Barry SM,Lloyd-Owen SJ,Madge SJ,Cozzi-Lepri A,Evans AJ,Phillips AN,Johnson MA

    更新日期:2002-04-01 00:00:00

  • RNA amplification of the HIV-1 Pol and env regions on dried serum and plasma spots.

    abstract:BACKGROUND:Dried sample spots have molecular applications, but few data are available on conditions of HIV-1 RNA amplification. OBJECTIVES:To determine the impact of (i) the sample type (plasma or serum), (ii) various storage periods, (iii) transfer at ambient temperature of the dried spots via postal mail, and (iv) t...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Dachraoui R,Brand D,Brunet S,Barin F,Plantier JC

    更新日期:2008-08-01 00:00:00

  • HIV testing in community settings in resource-rich countries: a systematic review of the evidence.

    abstract:OBJECTIVES:Community HIV testing represents an opportunity for diagnosing HIV infection among individuals who may not have contact with health services, especially in hard-to-reach groups. The aim of this review was to assess the evidence for feasibility, acceptability and effectiveness of HIV testing strategies in com...

    journal_title:HIV medicine

    pub_type: 杂志文章,评审


    authors: Thornton AC,Delpech V,Kall MM,Nardone A

    更新日期:2012-08-01 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

  • Multidisciplinary collaborative integrated management of increasingly prominent HIV complications in the post-cART era.

    abstract:OBJECTIVES:With the prolonged survival time of AIDS patients, complications of various systems and organs of HIV infection are increasingly prominent. These diseases have become the major factors influencing the quality of life and prognosis of HIV-infected persons, and multidisciplinary cooperation treatment is urgent...

    journal_title:HIV medicine

    pub_type: 杂志文章,评审


    authors: Lin L,Li TS

    更新日期:2020-12-01 00:00:00

  • Prevalence of cryptococcal antigenuria at initial HIV diagnosis in KwaZulu-Natal.

    abstract:OBJECTIVES:The World Health Organization (WHO) recommends screening HIV-infected people for cryptococcal antigens to identify cryptococcosis, a major cause of AIDS-related deaths. As the burden of cryptococcosis is unknown in South Africa's KwaZulu-Natal province, we assessed the cryptococcal antigenuria prevalence amo...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Drain PK,Kleene JM,Coleman SM,Losina E,Katz JN,Giddy J,Ross D,Freedberg KA,Bassett IV

    更新日期:2015-11-01 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

  • Risk factors for death among patients in French Guiana: 1996-2005.

    abstract::Risk factors for death in an HIV-infected cohort in French Guiana were studied in 1374 patients between 1996 and 2005. Of these patients, 48.5% were male and 76% were immigrants. Covariates were measured at the time of consultation. There were 223 deaths. Addictions [adjusted hazard ratio (HR)=13; 95% confidence inter...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Nacher M,Huber F,El Guedj M,Vaz T,Magnien C,Djossou F,Randrianjohany A,Alvarez F,Couppié P

    更新日期:2007-10-01 00:00:00

  • Cerebrospinal fluid HIV RNA in persons living with HIV.

    abstract:OBJECTIVES:Despite adequate suppression of plasma HIV RNA, viral escape in cerebrospinal fluid (CSF) is widely reported. Rates of CSF HIV RNA escape vary in the literature. In persons living with HIV (PLWH) undergoing lumbar puncture examination for clinical reasons, we assessed rates of CSF HIV RNA escape. METHODS:Pe...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Di Carlofelice M,Everitt A,Muir D,Winston A

    更新日期:2018-05-01 00:00:00

  • Prevalence and factors associated with renal impairment in HIV-infected patients, ANRS C03 Aquitaine Cohort, France.

    abstract:OBJECTIVES:The aims of the present study were to estimate the prevalence of renal impairment (RI) among HIV-infected adult patients and to investigate the associated factors. METHODS:A cross-sectional survey was conducted in a French hospital-based cohort. Clearance of creatinine (CC) was calculated using the Cockcrof...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Déti EK,Thiébaut R,Bonnet F,Lawson-Ayayi S,Dupon M,Neau D,Pellegrin JL,Malvy D,Tchamgoué S,Dabis F,Morlat P,Groupe d'Epidémiologie Clinique du SIDA en Aquitaine.

    更新日期:2010-05-01 00:00:00

  • Chronic hepatitis B increases mortality and complexity among HIV-coinfected patients in South Africa: a cohort study.

    abstract:OBJECTIVES:To assess the effect of chronic hepatitis B on survival and clinical complexity among people living with HIV following antiretroviral therapy (ART) initiation. METHODS:We evaluated mortality and single-drug substitutions up to 3 years from ART initiation (median follow-up 2.75 years; interquartile range 2-3...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Velen K,Charalambous S,Innes C,Churchyard GJ,Hoffmann CJ

    更新日期:2016-10-01 00:00:00

  • Long-term (96-week) follow-up of antiretroviral-naïve HIV-infected patients treated with first-line lopinavir/ritonavir monotherapy in the MONARK trial.

    abstract:BACKGROUND:The toxicities, cost and complexity of triple combinations warrant the search for other treatment options, such as boosted protease inhibitor (PI) monotherapy. MONotherapy AntiRetroviral Kaletra (MONARK) is the first randomized trial comparing lopinavir/ritonavir monotherapy to triple combination therapy wit...

    journal_title:HIV medicine

    pub_type: 杂志文章,随机对照试验


    authors: Ghosn J,Flandre P,Cohen-Codar I,Girard PM,Chaix ML,Raffi F,Dellamonica P,Ngovan P,Norton M,Delfraissy JF,MONARK Study Group.

    更新日期:2010-02-01 00:00:00

  • Impact of highly active antiretroviral therapy on the maturation of anti-HIV-1 antibodies during primary HIV-1 infection.

    abstract:OBJECTIVES:To study the impact of highly active antiretroviral therapy (HAART) on isotype switching and avidity maturation of HIV-1-specific immunoglobulin G (IgG) in patients with primary HIV-1 infection (PHI). METHODS:We studied the emergence and the evolution of anti-HIV IgG antibodies by quantitative immunoblottin...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究


    authors: Adalid-Peralta L,Grangeot-Keros L,Rudent A,Ngo-Giang-Huong N,Krzysiek R,Goujard C,Deveau C,Le Gall M,Meyer L,Emilie D,Rouzioux C

    更新日期:2006-11-01 00:00:00

  • Sweden, the first country to achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 continuum of HIV care targets.

    abstract:OBJECTIVES:The Joint United Nations Programme on HIV/AIDS (UNAIDS)/World Health Organization (WHO) 90-90-90 goals propose that 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy (ART), and 90% of those should have durable viral suppression. We ha...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Gisslén M,Svedhem V,Lindborg L,Flamholc L,Norrgren H,Wendahl S,Axelsson M,Sönnerborg A

    更新日期:2017-04-01 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

  • A randomized study investigating the efficacy and safety of amprenavir in combination with low-dose ritonavir in protease inhibitor-experienced HIV-infected adults.

    abstract:OBJECTIVES:To compare the safety and efficacy of amprenavir [APV/j Agenerase trade mark; GlaxoSmithKline, [Ware, UK; 600 mg twice a day (bid)] boosted with low-dose ritonavir (RTV, 100 mg bid) with those of other protease inhibitors (PIs) in PI-experienced HIV-infected patients. STUDY DESIGN:Parallel-group, randomized...

    journal_title:HIV medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Pulido F,Katlama C,Marquez M,Thomas R,Clumeck N,Pedro Rde J,Cattelan AM,Zhu C,Tymkewycz P

    更新日期:2004-07-01 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

  • Subgroup analysis of virological response rates with once- and twice-daily darunavir/ritonavir in treatment-experienced patients without darunavir resistance-associated mutations in the ODIN trial.

    abstract:BACKGROUND:ODIN (once-daily darunavir in treatment-experienced patients) was a 48-week, phase III, randomized, open-label trial comparing once-daily (qd) darunavir/ritonavir (DRV/r) 800/100 mg with twice-daily (bid) DRV/r 600/100 mg, both with an optimized background regimen [OBR; at least two nucleoside reverse transc...

    journal_title:HIV medicine

    pub_type: 杂志文章,随机对照试验


    authors: Sension M,Cahn P,Domingo P,Hodder S,Opsomer M,Lathouwers E,Van de Casteele T,Tomaka F

    更新日期:2013-08-01 00:00:00

  • Hyperlactataemia in HIV-infected subjects initiating antiretroviral therapy in a large randomized study (a substudy of the INITIO trial).

    abstract:OBJECTIVE:The aim of the study was to evaluate the predictive value of clinical and molecular risk factors, including peripheral blood mononuclear cell (PBMC) mitochondrial DNA (mtDNA) and mitochondrial RNA (mtRNA), for the development of lactic acidosis (LA) and symptomatic hyperlactataemia (SHL). METHODS:In a substu...

    journal_title:HIV medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Feeney ER,Chazallon C,O'Brien N,Meiffrédy V,Goodall RL,Aboulker JP,Cooper DA,Yeni P,Mallon PW,INITIO Trial International Co-ordinating Committee.

    更新日期:2011-11-01 00:00:00

  • Yoga lifestyle intervention reduces blood pressure in HIV-infected adults with cardiovascular disease risk factors.

    abstract:OBJECTIVE:People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves C...

    journal_title:HIV medicine

    pub_type: 杂志文章,随机对照试验


    authors: Cade WT,Reeds DN,Mondy KE,Overton ET,Grassino J,Tucker S,Bopp C,Laciny E,Hubert S,Lassa-Claxton S,Yarasheski KE

    更新日期:2010-07-01 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

  • Attitudes towards new HIV biomedical prevention technologies among a cohort of HIV-negative gay men in Sydney, Australia.

    abstract:OBJECTIVES:The aim of the study was to explore the awareness of rectal microbicides, the use of pre-exposure prophylaxis (PREP) and the willingness to participate in biomedical HIV prevention trials in a cohort of HIV-negative gay men. METHODS:In a community-based cohort study, HIV-negative homosexually active men in ...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: Poynten IM,Jin F,Prestage GP,Kaldor JM,Imrie J,Grulich AE

    更新日期:2010-04-01 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

  • Characteristics and response to antiretroviral therapy of HIV-1-infected patients born in Africa and living in France.

    abstract:BACKGROUND:The world-wide AIDS epidemic is reflected in Western Europe in an increasing number of HIV-infected persons who originate from Africa. We describe the characteristics and response to antiretroviral therapy (ART) of HIV-infected patients born in Africa and living in France. METHODS:Analysis of data from the ...

    journal_title:HIV medicine

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Breton G,Lewden C,Spire B,Salmon D,Brun-Vézinet F,Duong M,Allavena C,Leport C,Salamon R,APROCO COPILOTE ANRS CO8 Study Group.

    更新日期:2007-04-01 00:00:00

  • High HIV prevalence in a southern semi-rural area of Mozambique: a community-based survey.

    abstract:BACKGROUND:Southern African countries have borne the brunt of the HIV/AIDS pandemic. Monitoring epidemiological dynamics is critical to identify the populations at greatest risk of infection and to guide control strategies. METHODS:A cross-sectional community-based study to determine age- and sex-specific HIV prevalen...

    journal_title:HIV medicine

    pub_type: 杂志文章


    authors: González R,Munguambe K,Aponte J,Bavo C,Nhalungo D,Macete E,Alonso P,Menéndez C,Naniche D

    更新日期:2012-11-01 00:00:00