Fig. 4

The interplay of residual viremia and HIV-1 reservoir size and long-term dynamics. a The predicted log10 total HIV-1 DNA slope conditional on the effect of all other covariables and the observed viral load (constantly < 50 HIV-1 RNA copies/ml plasma, occurrence of viral blips, or low-level viremia) within 1.5–5.4 years after initiation of ART. b The predicted log10 total HIV-1 DNA slope and 95% confidence interval conditional on the effect of all other previously included covariables and the observed mean log10 plasma HIV-1 RNA (viral blips and low-level viremia) within 1.5–5.4 years after initiation of ART is shown in green. This was calculated using the R-package margins. The result of fitting a spline as the smoothing function for mean log10 plasma HIV-1 RNA (viral blips and low-level viremia) within 1.5–5.4 years after initiation of ART while correcting for the previously included covariables is shown in red. We choose a thin plate regression spline with dimension 20 of the basis. c Conceptual figure showing the observed associations between: (i) residual viremia, (ii) the HIV-1 reservoir size 1.5 years after initiation of ART, and (iii) the decay of the HIV-1 reservoir 1.5–5.4 years after initiation of ART. Residual viremia captured both, low-level viremia and viral blips, from 1.5 to 5.4 years after initiation of ART and was thus indicated as the mean log10 HIV-1 RNA. Arrows indicate a positive effect size, i.e., an enhancing effect. The blunted arrow indicates an inhibiting effect. p values were derived using linear regression. ART antiretroviral therapy. d Two possible scenarios explaining the interplay between residual viremia and HIV-1 reservoir size and long-term dynamics