BMC infectious diseases
Understanding viral blips in people with HIV on antiretroviral therapy: a nationwide Swedish cohort study of 4,210 individuals
By Sörstedt E, Nilsson S, Sönnerborg A and 7 others.
Abstract
Background
The pathogenesis and clinical consequences of viral blips are not completely understood. The aim of this large nationwide study was to investigate the incidence of viral blips and factors associated with them, with particular attention to the third (core) agent class-comparing integrase strand transfer inhibitor (INSTI)-based regimens with non-nucleoside reverse transcriptase inhibitor (NNRTI)- and protease inhibitor (PI)-based regimens.
Methods
From the Swedish national InfCareHIV cohort, we included treatment-naïve adults who commenced antiretroviral therapy (ART) from 1 January 2007; data were extracted on 30 September 2020. Viral blips were defined as transient plasma HIV RNA levels between 50 and 500 copies/mL preceded and followed by HIV RNA < 50 copies/mL. Virological failure was defined as two consecutive HIV RNA samples > 200 copies/mL or a single sample of HIV RNA > 1,000 copies/mL, in previously suppressed individuals with more than 12 months since ART initiation. Cox regression was used for event analyses.