The Journal of Practical Medicine ›› 2021, Vol. 37 ›› Issue (16): 2102-2108.doi: 10.3969/j.issn.1006⁃5725.2021.16.014

• Clinical Research • Previous Articles     Next Articles

Impact of HIV low ⁃level viraemia on virological failure among HIV/AIDS people receiving antiretroviral therapy

AN Jing*，LAO Yunfei，TANG Songyuan.   

  1. Yunnan Provincial Infectious Disease Hospital，Yunnan AIDS Care Center/ AIDS Clinical Management Office，Kunming 650301，China；*Kunming Medical University，Kunming 650500，China

  • Online:2021-08-25 Published:2021-08-25

Abstract:

Objective To learn about the impact of HIV low⁃level viraemia on subsequent virological failure in people living with HIV/AIDS undergoing antiretroviral therapy（ART）. Methods A retrospective observational study was conducted based on the data of Yunnan′s cases extracted from National HIV/AIDS Comprehensive Information Management System from January 1，2004 to December 31，2018. Multivariate Cox regression was used to analyze the Hazard Ratio（HR）of virological failure in patients with different levels and frequencies of low⁃level viraemia compared with those without occurrence of low⁃level viraemia. They were divided into first⁃line ART cohort （regimen without LPV/r）and second ⁃line ART cohort（regimen with LPV/r ）. Results A total of 93，944 cases were included in the analysis. In the first⁃line treatment cohort，compared with that without low⁃level viraemia，the risk rate of virological failure in the 51 ~ 199 copy /mL group was the same，but 1.39 times increased in the 200 ~ 399 copy /mL group，and 2.02 times in the 400 ~ 999 copy /mL group. Regarding to the frequencies of low viraemia occurrence，the risk of virological failure was gradually increased in cases suffering from low ⁃level viraemia once （HR = 1.28，95%CI：1.21 ~ 1.36，P < 0.001），twice consecutively（HR = 1.38，95%CI：1.22 ~ 1.55，P < 0.001） and several times consecutively（HR = 1.76，95%CI：1.48 ~ 2.10，P < 0.001）. In the second⁃line treatment cohort， the risk of virological failure was unchanged in the 51 ~ 199 copy/mL group，1.33 times increased in the 200 ~ 399 copy/mL group，and 2.26 times in the 400 ~ 999 copy/mL group，when compared with cases without low⁃level virae⁃ mia. There was an increased risk of virological failure in cases suffering from low⁃level viraemia once（HR = 1.27， 95%CI：1.11 ~ 1.46）and twice consecutively（HR = 1.38，95%CI：1.01 ~ 1.88）. Conclusion The ART cases suffering from viraemia with 200⁃999 copy /mL，or suffering from viraemia for once or or two or more times have the increased risk of subsequent virological failure. 

Key words:

HIV/AIDS, antiretroviral therapy, low?level viraemia, virological failure