Joya C, et al. - Using data from the U.S. Military HIV Natural History Study (NHS), researchers examined if persistent low-level viremia (pLLV) is associated with virologic failure (VF). They included 2006 subjects in whom initiation of combination antiretroviral therapy (ART) was undertaken with two or more VLs measures with a lower limit of detection of <50 copies/mL. A confirmed VL ≥200 copies/mL or any VL>1000 copies/mL that defined VF was reported in 383 subjects (19%). pLLV (3.46) and hLV (2.29) were noted to be associated with VF after adjusting for demographics, VL, CD4 counts, ART regimen, prior use of mono or dual antiretrovirals, and time to ART start. Data thereby support the evidence suggesting deleterious virologic consequences in correlation with persistent LLV.