Xiao Jiayang, Yang Xueying, Ma Yunqing, Olatosi Bankole, Weissman Sharon, Li Xiaoming, Zhang Jiajia
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
AIDS Care. 2025 Jan;37(1):33-42. doi: 10.1080/09540121.2024.2411270. Epub 2024 Oct 7.
Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50-59 years vs 18-29 years, aHR: 0.43, 95% CI: [0.34, 0.55]) were more likely to experience VR. Black individuals (Black vs White, IRR: 1.61, 95% CI [1.38, 1.88]) had more VR, while MSM (MSM vs Heterosexual, IRR: 0.68, 95% CI: [0.57, 0.81]) was negatively associated with number of VsR. Furthermore, individuals engaging illicit drug use (IDU) (aOR: 1.50, 95% CI: [1.03, 2.17]) were more likely to experience VR in the MSM subgroup. This study highlighted the alarming risk factors related to VR among PWH. Tailored intervention should also be deployed for young, Black MSM patients with substance use for more effective and targeted public health strategies concerning VR.
对艾滋病毒感染者（PWH）的病程进行常规病毒反弹（VR）监测很重要。本研究调查了男男性行为者（MSM）首次出现VR的时间、VR次数的风险因素及其与VR病史的关联。研究纳入了2005年1月至2018年12月期间诊断出的8176例成年PWH，随访至2021年7月。我们使用Cox模型分析首次出现VR的时间，使用Poisson模型分析VR次数，并使用逻辑回归分析MSM中的VR病史。较年轻的个体（50 - 59岁与18 - 29岁相比，校正风险比：0.43，95%置信区间：[0.34, 0.55]）更易出现VR。黑人个体（黑人与白人相比，发病率比值比：1.61，95%置信区间[1.38, 1.88]）出现VR的次数更多，而MSM（MSM与异性恋相比，发病率比值比：0.68，95%置信区间：[0.57, 0.81]）与VR次数呈负相关。此外，在MSM亚组中，从事非法药物使用（IDU）的个体（校正优势比：1.50，95%置信区间：[1.03, 2.17]）更易出现VR。本研究突出了PWH中与VR相关的惊人风险因素。对于有物质使用问题的年轻黑人MSM患者，也应采取针对性干预措施，以制定更有效、更具针对性的VR公共卫生策略。
