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In patients receiving antiretroviral therapy (ART), intermittent episodes of increased viremia can herald emerging resistance. In untreated patients, however, such bursts of viremia may be attributable to concomitant infections or to HIV-1 superinfection.
To explore these potential etiologies, investigators conducted a retrospective, cross-sectional study among 14 HIV-infected patients who were not receiving treatment when they had a sudden ≥5-fold increase in viral load from one clinic visit to the next during 2005 or 2006. All the patients were receiving HIV care at a single Amsterdam clinic where viral loads were monitored every 3 months or, in patients with sudden increases in viremia, every 4 weeks. Ten of the patients had never receive…