Incidence of low-level viraemia and influencing factors in people living with HIV/AIDS in Henan

  Objective  To analyze the incidence of low-level viraemia (LLV) and influencing factors in people living with HIV/AIDS (PLWHA) in Henan province and provide evidence for the prevention of LLV.

  Methods  In this retrospective cohort study, the incidence data of LLV in PLWHA with access to ART in Henan were downloaded from China disease prevention and control information system for the descriptive analysis on the demographic characteristics and treatment status of PLWHA. The PLWHA with access to ART from 2003 to 2022, age ≥18 years, ART duration ≥6 months, and at least one VL result were included in the analysis. Logistic regression model was used to analyze the influencing factors, and χ² test was used to analyze the incidence of LLV at different levels and frequencies and the risk for virus inhibition failure.

  Results  A total of 44 528 PLWHA cases were included in the analysis, in which 31143 were in persistent viral inhibition group (VL<50 copies/mL) and 13385 were in LLV group. The overall incidence of LLV was 30.06% (13385/44528), the incidences of LLV at 50–199 copies/mL, 200–399 copies/mL, 400–999 copies/mL were 15.05%, 6.35% and 8.66%, respectively, based on virus load, and the incidences of iLLV and pLLV were 23.48% and 6.58%, respectively, based on LLV frequency. The incidences of virus inhibition failure for LLV at low, medium and high levels were 13.70% (918/6702), 22.14% (626/2828) and 30.48% (1175/3855), respectively. The incidences of virus inhibition failure for iLLV and pLLV were 18.01% (1883/10453) and 28.51% (836/2932), respectively, and the differences in incidences of virus inhibition failure at different levels and frequencies were significant (P<0.001). Logistics regression analysis showed that the influencing factors for LLV in PLWHA included duration of ART, baseline CD4⁺T lymphocyte count, baseline disease symptoms, baseline type of complications, onterval from HIV diagnosis to treatment initiation, initial treatment regimen, and possible change of treatment regimen.

  Conclusion  There is a high risk for LLV in PLWHA in Henan, which would increase the risk of virus inhibition failure. It is necessary to start antiviral treatment as earlier as possible and improve patients’ compliance.