Modest deviations from optimal adherence to antiretroviral therapy promote residual HIV-1 replication in the absence of virological rebound in plasma

Background Modern antiretroviral therapy (ART) is assumed to allow a certain degree of nonadherence while still maintaining complete suppression of viral replication ("forgiveness”), as virological suppression, measured by the commercial plasma viral load assays, is common at adherence levels >55-70% [1]. Yet, it is unknown whether HIV-1 replication is completely suppressed at these levels of adherence. [2]Here we investigated whether modest nonadherence to ART influences levels of HIV-1 RNA and DNA in peripheral blood mononuclear cells (PBMC).