接受抗逆转录病毒治疗的HIV患者持续低水平病毒血症的结局：一项前瞻性队列研究。

Outcomes of persistent low-level viremia among HIV patients on antiretroviral therapy: A prospective cohort study.

作者信息

Ding Haibo, Xu Junjie, Liu Jing, Wang Qi, Kang Jing, Li Xiaolin, Zhang Zining, Han Xiaoxu, Jiang Yongjun, Geng Wenqing, Shang Hong

机构信息

NHC Key Laboratory of AIDS Immunology, China Medical University, National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.

Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China.

出版信息

HIV Med. 2022 Mar;23 Suppl 1:64-71. doi: 10.1111/hiv.13250.

DOI:10.1111/hiv.13250

PMID:35293103

Abstract

INTRODUCTION

We aimed to investigate the relationship between low-level viremia (LLV) and virological failure (VF), death, and non-AIDS events (NAEs).

METHODS

A prospective cohort study of people living with HIV (PLHIV) on antiretroviral therapy (ART) was conducted from 2011-2018 at an HIV clinic in Shenyang, China. The incidence of VF and the mortality and NAEs due to LLV were assessed. Cox proportional hazards regression was performed to investigate risk factors for VF, mortality, and NAEs.

RESULTS

In total, 1288 patients, contributing 3915 person-years of follow-up (median follow-up, 2.5 years [interquartile range: 2-4 years]), were enrolled. Thirty-one patients (2.4%) experienced VF, 5 (0.4%) died, and 38 (3.0%) experienced NAEs. The risk of VF was significantly increased among patients with a viral load (VL) of 200-499 copies/mL (adjusted hazard ratio [aHR]: 14.92, 95% confidence interval [CI]: 5.92-37.60) or 500-999 copies/mL (aHR: 13.68, 95% CI: 3.61-51.87), but not among patients with a VL of 50-199 copies/mL (aHR: 3.10, 95% CI: 0.86-11.09). The risk of NAEs was significantly increased among patients with LLV (aHR: 7.33, 95% CI: 3.73-14.42). Compared to no LLV, a VL of 50-199 copies/mL (aHR: 4.11, 95% CI: 1.73-9.74), 200-499 copies/mL (aHR: 18.31, 95% CI: 6.66-50.33), and 500-999 copies/mL (aHR: 21.34, 95% CI: 5.69-80.01) showed higher risk of NAEs.

CONCLUSION

Low-level viremia was associated with VF and NAEs. Patients with LLV, especially those with a VL ≥200 copies/mL, may need more frequent VL testing and NAE screening.

摘要

引言

我们旨在研究低水平病毒血症（LLV）与病毒学失败（VF）、死亡及非艾滋病相关事件（NAEs）之间的关系。

方法

2011年至2018年，在中国沈阳的一家艾滋病诊所对接受抗逆转录病毒治疗（ART）的艾滋病病毒感染者（PLHIV）进行了一项前瞻性队列研究。评估了VF的发生率以及LLV导致的死亡率和NAEs。采用Cox比例风险回归分析来研究VF、死亡率和NAEs的危险因素。

结果

共纳入1288例患者，随访时间总计3915人年（中位随访时间为2.5年[四分位间距：2 - 4年]）。31例患者（2.4%）发生VF，5例（0.4%）死亡, 38例（3.0%）发生NAEs。病毒载量（VL）为200 - 499拷贝/mL（调整后风险比[aHR]：14.92，95%置信区间[CI]：5.92 - 37.60）或500 - 999拷贝/mL（aHR：13.68，95% CI：3.61 - 51.87）的患者发生VF的风险显著增加，但VL为50 - 199拷贝/mL的患者未出现这种情况（aHR：3.10，95% CI：0.86 - 11.09）。LLV患者发生NAEs的风险显著增加（aHR：7.33，95% CI：3.73 - 14.42）。与无LLV的患者相比，VL为50 - 199拷贝/mL（aHR：4.11，95% CI：1.73 - 9.74）、200 - 499拷贝/mL（aHR：18.31，95% CI：6.66 - 50.33）和500 - 999拷贝/mL（aHR：21.34，95% CI：5.69 - 80.01）的患者发生NAEs的风险更高。