0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Durable HIV Treatment Benefit Despite Low-Level Viremia:  Reassessing Definitions of Success or Failure

Steven G. Deeks, MD
JAMA. 2001;286(2):224-226. doi:10.1001/jama.286.2.224.
Text Size: A A A
Published online

Extract

Left untreated, human immunodeficiency virus (HIV) replicates at a rapid rate, with the eventual production of billions of new virus particles per day. Given the propensity of HIV to mutate, the possibility exists that each newly produced virus contains at least 1 new mutation. Thus, from a darwinian perspective, ongoing viral replication in the presence of therapy should result in the rapid selection of drug resistance mutations and subsequent virologic rebound. These basic principles have provided the theoretical context for the "hit hard" therapeutic approach to HIV disease.1 According to current treatment guidelines,13 complete viral suppression should be the goal of therapy. Once therapy is initiated, plasma viremia, as measured by the concentration of viral RNA in plasma, should decrease to below the level of detection using the most sensitive assay available.2,3 Persistent viremia suggests ongoing viral replication and treatment failure. The findings from 2 articles in this issue of THE JOURNAL raise questions about this conceptual framework, and based on data from the 2 studies, it may be argued that "complete" viral suppression may not be a prerequisite for durable treatment benefit.

Topics

hiv ; viremia

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 32

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();