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An established and growing body of evidence suggests that persistent low-level viremia (LLV), or even intermittent or isolated detectable viral loads <50 copies/mL, is associated with increased risk for subsequent virologic failure. However, the optimal clinical strategy for managing isolated or persistent LLV remains largely unknown.
To explore this issue, researchers in Montreal studied the cumulative incidence of virologic failure (defined as viral load >1000 copies/mL) during ≤5 years of follow-up in individuals on antiretroviral therapy with persistent LLV for 6 to 12 months. The 1860 patients (predominantly white men who have sex with men) were divided into four groups by viral load: persistent viremia at 50 to 199 copies/mL, at 200 to…