Persistent low-Level viremia in persons living with HIV undertreatment: an unresolved status

Antiretroviral therapy (ART) allows suppressed viremia to reach less than 50 copies/mL in most treated persons living with HIV (PLWH). However, the existence of PLWH that show events of persistent low-level viremia (pLLV) between 50 and 1000 copies/mL and with different virological consequences have...

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Detalles Bibliográficos
Autores: Crespo Bermejo, Celia, Ramírez de Arellano, Eva, Lara Aguilar, Violeta, Valle Millares, Daniel, Gómez-Lus Centelles, María Luisa, Madrid González, Ricardo, Martín Carbonero, Luz, Briz Sebastián, Verónica
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/4920
Acceso en línea:https://hdl.handle.net/20.500.14352/4920
Access Level:acceso abierto
Palabra clave:578.828
616.98
HIV
pLLV
ART adherence
VF
Reservoir
Clonal expansion
Immune activation
Mortality
Aids events and nades
Enfermedades infecciosas
Microbiología (Biología)
3205.05 Enfermedades Infecciosas
2414 Microbiología
2420 Virología
Descripción
Sumario:Antiretroviral therapy (ART) allows suppressed viremia to reach less than 50 copies/mL in most treated persons living with HIV (PLWH). However, the existence of PLWH that show events of persistent low-level viremia (pLLV) between 50 and 1000 copies/mL and with different virological consequences have been observed. PLLV has been associated with higher virological failure (VF), viral genotype resistance, adherence difficulties and AIDS events. Moreover, some reports show that pLLV status can lead to residual immune activation and inflammation, with an increased risk of immunovirological failure and a pro-inflammatory cytokine level which can lead to a higher occurrence of non-AIDS defining events (NADEs) and other adverse clinical outcomes. Until now, however, published data have shown controversial results that hinder understanding of the true cause(s) and origin(s) of this phenomenon. Molecular mechanisms related to viral reservoir size and clonal expansion have been suggested as the possible origin of pLLV. This review aims to assess recent findings to provide a global view of the role of pLLV in PLWH and the impact this status may cause on the clinical progression of these patients.