title: Antiretroviral regimen and suboptimal medication adherence are associated with low-level human immunodeficiency virus viremia.
abstract: Episodes of human immunodeficiency virus low-level viremia (LLV) are common in the clinical setting, but its association with antiretroviral therapy (ART) regimen and adherence remains unclear. Antiretroviral therapy adherence was evaluated in participants of the Research on Access to Care in the Homeless cohort by unannounced pill counts. Factors associated with increased risk of LLV include treatment with a protease inhibitor (PI)-based regimen (ritonavir-boosted PI vs nonnucleoside reverse-transcriptase inhibitor: adjusted hazard ratio [HR], 3.1; P = .01) and lower ART adherence over the past 3 months (HR, 1.1 per 5% decreased adherence, adjusted; P = .050). Patients with LLV may benefit from ART adherence counseling and potentially regimen modification.
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts ; Meharry Medical College , Nashville, Tennessee.
authors.forename: Christina
authors.initials: C
authors.lastname: Konstantopoulos
authors.affiliation: Center for Biostatistics in AIDS Research , Harvard School of Public Health , Boston, Massachusetts.
authors.forename: Heather
authors.initials: H
authors.lastname: Ribaudo
authors.affiliation: Division of HIV/AIDS , San Francisco General Hospital, University of California.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ragland
authors.affiliation: Massachusetts General Hospital, Harvard Medical School , Boston.
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts.
authors.forename: Jonathan Z
authors.initials: JZ
authors.lastname: Li
keywords: adherence; antiretroviral therapy; low-level viremia