Aldredge Amalia, Patel Corrina, Sheth Anandi N, Collins Lauren F
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Ponce de Leon Center, Grady Health System, 49 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA.
Mercer University School of Medicine, Macon, GA, USA.
Curr HIV/AIDS Rep. 2025 Jun 26;22(1):39. doi: 10.1007/s11904-025-00743-2.
Low-level viremia (LLV) remains common in the modern HIV treatment era. We sought to clarify a unified definition of LLV, examine current LLV risk factors, assess outcomes for people with LLV, explore sex and gender differences, and evaluate management updates for people who develop LLV.
There continue to be varied definitions of LLV without standardization, making comparison of clinical research findings challenging. Potential LLV risk factors have expanded and early data suggest that poor antiretroviral therapy adherence is unlikely to be the cause of most LLV; further, integrase strand transfer inhibitor use may be protective. Recent studies confirm that LLV is associated with virologic failure among other negative outcomes including a trend toward development of non-AIDS comorbidities; these effects may be more pronounced among women. Additional research, including randomized clinical trials, evaluating different strategies for managing LLV is urgently needed to prevent negative outcomes in persons with HIV.
在现代HIV治疗时代，低水平病毒血症（LLV）仍然很常见。我们试图明确LLV的统一定义，研究当前LLV的危险因素，评估LLV患者的预后，探讨性别差异，并评估发生LLV患者的管理更新情况。
LLV的定义仍然多种多样，缺乏标准化，这使得临床研究结果的比较具有挑战性。潜在的LLV危险因素已经扩大，早期数据表明，抗逆转录病毒治疗依从性差不太可能是大多数LLV的原因；此外，使用整合酶链转移抑制剂可能具有保护作用。最近的研究证实，LLV与病毒学失败以及其他负面结果相关，包括非艾滋病合并症的发展趋势；这些影响在女性中可能更为明显。迫切需要进行更多研究，包括随机临床试验，以评估管理LLV的不同策略，以预防HIV感染者出现负面结果。
