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In the current analysis, the RV ratio was defined as the ratio between the number of HIV RNA values of 1�C49?copies/mL observed during follow up and the number of viral loads tested during follow up. The RV ratio was stratified according to deciles. The primary analysis was the time to VR (Kaplan�CMeier curves, with comparison of groups A and B by the log-rank test). VR was defined as two consecutive HIV RNA values of >50?copies/mL after baseline. The proportion of VR between group A and B was compared by the chi-square test. Patients who changed any of the antiretroviral drugs in their regimen during follow up while their HIV RNA load was JQ1 censored (and follow up was interrupted) at the time of the switch. E-64 The multivariable analysis was performed using the Cox regression proportional hazard model. The outcome was the occurrence of VR. All of the statistical tests were two-sided at the 5% level, and were performed using SAS Software (release 9.2; SAS Institute, Cary, NC, USA). There were 739 eligible patients; at baseline, 446 (60.3%) had undetectable HIV RNA (group A) and 293 (39.7%) had RV (1�C49 HIV RNA copies/mL, group B). During a median (interquartile range) follow up of 30.8 (11.7�C32.9) months, 122 (27.4%) patients in group A and 81 (27.7%) patients in group B stopped at least one drug of the baseline regimen while their HIV RNA was www.selleckchem.com/products/r428.html 16/739 (2.17%) patients, 4/446 (0.9%) in group A and 12/293 (4.1%) in group B (p?0.007). Patients with RV at baseline had a higher probability of VR (log-rank test: p?0.003, Fig.?1a). One hundred and sixty-four (36.8%) patients in group A were able to maintain undetectable HIV RNA throughout the entire follow up, whereas the remaining 282 (63.2%) had at least one episode of RV during follow up. Four (1.4%) patients in group B always had HIV RNA values between 1 and 49?copies/mL, whereas 289 (98.6%) had at least one value of undetectable HIV RNA during follow up. All VRs occurred among patients who had at least one episode of RV during follow up, but none of the four patients who always had RV during follow up showed VR. Almost all VRs were observed in patients with an RV ratio of >0.5 during follow up (Fig.?1b). In the 16 patients who showed VR, the median (interquartile range) VL at VR was 165 (73�C1141) copies/mL. Resistance testing at VR was available in 4/16: a wild-type virus was detected in one case and drug-resistance mutations were found in the remaining three. Nine out of 16 had changed treatment after VR, whereas seven were able to attain