Continued Slow Decay of the Residual Plasma Viremia Level in HIV-1-Infected Adults Receiving Long-term Antiretroviral Therapy

J Infect Dis. 2016 Feb 15;213(4):556-60. doi: 10.1093/infdis/jiv433. Epub 2015 Sep 2.


We measured plasma human immunodeficiency virus type 1 (HIV-1) RNA levels by means of single-copy assay in 334 participants receiving virologically suppressive antiretroviral therapy (ART). A residual viremia load of ≥1 copy/mL after 4 years of ART was predicted by a higher pre-ART HIV-1 RNA level, higher CD8(+) T-cell count during treatment, and a lower ratio of CD4+ T cells to CD8+ T cells during treatment but not by initial ART regimen. In a longitudinal subset of 64 individuals, continued decay of the plasma HIV-1 RNA level was observed, with an average annual decrease of 6% and an estimated half-life of 11.5 years. In contrast to prior reports, the persistent viremia level continues to slowly decline during years 4-12 of suppressive ART.

Clinical trials registration: NCT00001137.

Keywords: CD4/CD8 ratio; HIV/AIDS; residual viremia; single-copy assay; viral decay.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage*
  • Antiretroviral Therapy, Highly Active / methods*
  • CD4-CD8 Ratio
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / virology*
  • HIV-1 / isolation & purification*
  • Humans
  • Longitudinal Studies
  • Male
  • Plasma / virology*
  • RNA, Viral / blood
  • Viral Load*


  • Anti-Retroviral Agents
  • RNA, Viral

Associated data


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