The Longer HIV Is Suppressed by Treatment, the Less Likely It Is to Rebound

Excellent adherence is known to be an important determinant of successful virologic suppression. However, for many patients, the years on treatment are turning into decades, and even the best intentions can lapse. Does adherence have to remain above 95% forever?

Researchers studied correlates of viral rebound among 1305 adults who initially had complete virologic responses to combination antiretroviral therapy started between 2000 and 2006. Overall, 274 individuals (21%) experienced rebound, after a median 2 years of suppression. Risk factors included younger age, injection-drug use, treatment initiation before 2002, and resistance to any class of antiretrovirals.

Longer duration of initial virologic suppression was protective against rebound…