Early action needed to prevent treatment failure, Nigerian research on detectable virus levels shows

National HIV treatment programmes should not wait until people with HIV have viral loads above 1000 copies/ml to provide enhanced adherence counselling, Nigerian researchers report in the journal Lancet Global Health. In a study of more than 100,000 people, the research group found that at least one in ten people with a detectable viral load below 1000 went on to experience a viral load above this level and 3% experienced treatment failure. All were at risk of developing drug resistance and might need to switch to more expensive second-line treatment. The study also found that small increases in viral load below 1000 – for example from 100 to 400 – resulted in big increases in the risk of virological non-suppression and treatment failure. The researchers say that physicians and treatment programmes should be more alert to the risks of low-level viraemia and act quickly when it is detected, to avoid serious long-term consequences. Low-level...