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With many currently recommended antiretroviral therapy (ART) regimens, complete adherence is not always needed to maintain HIV RNA levels <50 copies/mL. However, incomplete adherence may result in higher levels of residual viremia (1–49 copies/mL) that could replenish the viral reservoir, lead to viral rebound, or both.
In a recent, partially industry-funded study involving homeless or marginally housed HIV-infected adults in San Francisco, researchers used a single-copy assay to explore this issue. Eligibility requirements included treatment with combination ART (≥3 drugs) and viral load <50 copies/mL for ≥6 months. Adherence was assessed by unannounced pill counts. Sixty-four patients were included in the analysis (median age, 46; 81% male…