title: Rate of and predicting factors for virologic failure in HIV-infected patients with persistent low-level viremia under antiretroviral therapy.
abstract: To determine the rate of and predicting factors for virologic failure among HIV-infected patients with persistent low-level viremia (PLV) under antiretroviral therapy (ART), a retrospective cohort study was conducted among HIV-infected patients who experienced PLV under ART. Persistent low-level viremia was defined as HIV RNA level at 50 to 1000 copies/mL for at least 2 consecutive visits. Of 68 patients, mean ± standard deviation age was 35.2 ± 9.0 years and 64.7% were males. Median (interquartile range [IQR]) CD4 count was 94 (26-264) cells/mm(3) and baseline HIV RNA was 112 000 (1 090-461 500) copies/mL. During the median (IQR) follow-up period of 5.7 (3.4-10.3) years of ART, the rate of virologic failure was 38.2%. In multivariate analyses, only maximum amplitude of HIV RNA >400 copies/mL during PLV (hazard ratio = 5.668; 95% confidence interval, 1.888-17.014; P = .002) significantly predicted virologic failure. Patients with PLV >400 copies/mL are more likely to develop virologic failure and should be closely monitored. Interventional studies to prevent virologic failure in these patients are needed.
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Sastra
authors.initials: S
authors.lastname: Charuratananon
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand somnuek.sun@mahidol.ac.th.
authors.forename: Somnuek
authors.initials: S
authors.lastname: Sungkanuparph
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects; D014766:Viremia / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; antiretroviral therapy; persistent low-level viremia; predicting factors; virologic failure