The significance of very low-level viraemia detected by sensitive viral load assays in HIV infected patients on HAART

Summary Objectives Viral load (VL) measurement is critical for monitoring the effectiveness of highly active antiretroviral therapy (HAART). HAART aims to maintain plasma HIV RNA at undetectable levels. A VL Methods This retrospective case-control study included 69 individuals on HAART with VLLV. Immunological and virological outcomes over 36 months were compared to those of 70 well-matched controls with persistently undetectable VL. Results We detected no significant association between VLLV and the development of virological failure or inferior immunological outcomes. However, individuals with VLLV were significantly less likely to achieve subsequent sustained virological suppression (VL p p =0.002). Conclusions The significance of VLLV has been uncertain. Our results clearly suggest that VLLV is predictive of future suboptimal virological control, particularly a reduced likelihood of achieving virological suppression. Further work should confirm our findings and evaluate strategies for managing VLLV in HAART-treated patients.