Virological outcome and management of persistent low-level viraemia in HIV-1-infected patients: 11 years of the Swiss HIV Cohort Study. Antiviral Therapy
Boillat-Blanco et al. examined virological outcome and management in HIV-infected patients under combination antiretroviral therapy (cART) with persistent low-level viraemia (pLLV), defined as viral load (VL) of 21-400 cp/ml on ≥3 consecutive undetectable plasma samples. At week 48, 19/155 pLLV patients (12%) developed viral failure (VF), defined as VL >400 cp/ml. There was a strong correlation between pLLV of 201-400 cp/ml and VF. Compared to the control group, patients with pLLV were more often on unboosted protease inhibitor (PI) based and NRTI-only combination. No VF occurred in patients with persistent very LLV (21-49 c/ml). Most patients who changed ART had undetectable VLs thereafter.
These findings support cART modification for pLLV >200 cp/m.