Effect of HIV-1 low-level viraemia during antiretroviral therapy on treatment outcomes in WHO-guided South African treatment programmes: a multicentre cohort study

Lucas E Hermans, MD, Michelle Moorhouse, MBBCh, Sergio Carmona, MBBCh, Prof Diederick E Grobbee, MD, L Marije Hofstra, MD, Prof Douglas D Richman, MD, Hugo A Tempelman, MD, Willem D F Venter, MBBCh, Annemarie M J Wensing, MD

Antiretroviral therapy (ART) that enables suppression of HIV replication has been successfully rolled out at large scale to HIV-positive patients in low-income and middle-income countries. WHO guidelines for these regions define failure of ART with a lenient threshold of viraemia (HIV RNA viral load ≥1000 copies per mL). We investigated the occurrence of detectable viraemia during ART below this threshold and its effect on treatment outcomes in a large South African cohort.

In this large cohort, low-level viraemia occurred frequently and increased the risk of virological failure and switch to second-line ART. Strategies for management of low-level viraemia need to be incorporated into WHO guidelines to meet UNAIDS-defined targets aimed at halting the global HIV epidemic.

November 21, 2017
Year of publication
2017
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Journal and research articles
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