Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China
BackgroundThe frequency of low-level viremia (LLV) may vary across China. This study aims to analyze the epidemiological characteristics and related factors of LLV among HIV/AIDS patients in Guizhou Province from 2016 to 2022, and further analyze the impact of LLV on virological failure (VF).Researc...
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Frontiers Media S.A.
2025-07-01
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| Serie: | Frontiers in Public Health |
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| author | Yan Zheng Xinling Zha Hai Long Wenji Zeng Junhua Wang Yongming Yao Lu Huang Xiaotian Song Maosi Wang Yang Chen Yang Chen |
| author_facet | Yan Zheng Xinling Zha Hai Long Wenji Zeng Junhua Wang Yongming Yao Lu Huang Xiaotian Song Maosi Wang Yang Chen Yang Chen |
| author_sort | Yan Zheng |
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| description | BackgroundThe frequency of low-level viremia (LLV) may vary across China. This study aims to analyze the epidemiological characteristics and related factors of LLV among HIV/AIDS patients in Guizhou Province from 2016 to 2022, and further analyze the impact of LLV on virological failure (VF).Research design and methodsIn this retrospective cohort study, we analyzed people living with HIV/AIDS whose demographic data, CD4+ T lymphocyte count, and viral load. LLV was defined as at least one VL measurement between 50 and 999 copies/mL after ART. Viral suppression refers to the maintenance of a VL < 50 copies/mL after undergoing ART. VF was defined as a VL ≥ 1,000 copies/mL after ART. To examine and compare the incidence of LLV at different levels, this study divided LLV into three groups based on previous research definitions: low-level LLV (LLLV) ranging from 50 to 199 copies/mL, medium-level LLV (MLLV) ranging from 200 to 399 copies/mL, and high-level LLV (HLLV) ranging from 400 to 999 copies/mL. LLV occurrence frequency was divided into two groups: intermittent LLV (iLLV) was defined as one independent LLV with both the previous and the subsequent viral load below the lower limit of detection. Persistent LLV (pLLV) was defined as at least two consecutive episodes of LLV. We divided the people living with HIV/AIDS into two sub-cohorts based on whether they experienced LLV. Non-LLV was defined as never having experienced LLV. We compared the occurrence of LLV at different levels and frequencies, as well as the risk of virological failure (VF), using the Chi-square test. Non-conditional binary logistic regression analysis was used to identify factors influencing LLV.ResultsIn total, 28,613 cases of infection were analyzed, with 33.72% (9,649/28,613) exhibiting LLV. The LLV proportion rates were 20.69, 6.50, and 6.48% in the low-level LLV (LLLV) (50–199 copies/mL), medium-level LLV (MLLV) (200–399 copies/mL), and high-level LLV (HLLV) (400–999 copies/mL) groups, respectively. The intermittent LLV (iLLV) and persistent LLV (pLLV) groups had LLV rates of 28.65 and 5.07%, respectively. The VF rates were 6.18, 11.79, and 13.70% in the LLLV, MLLV, and HLLV groups, respectively (p < 0.001). The iLLV and pLLV groups had VF rates of 8.82 and 8.14%, respectively (p = 0.397). Multivariate logistic regression analysis revealed that the gender, ethnicity, age at antiretroviral therapy initiation, baseline CD4+ T lymphocyte count, and current treatment regimen were factors influencing the occurrence of LLV.ConclusionThe incidence of LLV among people living with HIV/AIDS treated with INSTI-sparing regimens in Guizhou Province is relatively high and is mainly influenced by factors such as age, CD4+ T lymphocyte count and treatment regimens. A comprehensive assessment of these factors is essential to implement targeted interventions that prevent LLV and enhance the effectiveness of antiretroviral therapy. |
| format | Article |
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| institution | Matheson Library |
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| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-affbd5a289834e398ad3f5c5ed910dfd2025-07-30T05:28:07ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15352851535285Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, ChinaYan Zheng0Xinling Zha1Hai Long2Wenji Zeng3Junhua Wang4Yongming Yao5Lu Huang6Xiaotian Song7Maosi Wang8Yang Chen9Yang Chen10Guiyang Public Health Clinical Center, Guiyang, ChinaSchool of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, ChinaGuiyang Public Health Clinical Center, Guiyang, ChinaGuiyang Public Health Clinical Center, Guiyang, ChinaSchool of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, ChinaGuizhou Center For Disease Control And Prevention, Guiyang, ChinaGuizhou Center For Disease Control And Prevention, Guiyang, ChinaGuizhou Center For Disease Control And Prevention, Guiyang, ChinaGuizhou Center For Disease Control And Prevention, Guiyang, ChinaGuizhou Center For Disease Control And Prevention, Guiyang, ChinaGuizhou Medical University, Guiyang, ChinaBackgroundThe frequency of low-level viremia (LLV) may vary across China. This study aims to analyze the epidemiological characteristics and related factors of LLV among HIV/AIDS patients in Guizhou Province from 2016 to 2022, and further analyze the impact of LLV on virological failure (VF).Research design and methodsIn this retrospective cohort study, we analyzed people living with HIV/AIDS whose demographic data, CD4+ T lymphocyte count, and viral load. LLV was defined as at least one VL measurement between 50 and 999 copies/mL after ART. Viral suppression refers to the maintenance of a VL < 50 copies/mL after undergoing ART. VF was defined as a VL ≥ 1,000 copies/mL after ART. To examine and compare the incidence of LLV at different levels, this study divided LLV into three groups based on previous research definitions: low-level LLV (LLLV) ranging from 50 to 199 copies/mL, medium-level LLV (MLLV) ranging from 200 to 399 copies/mL, and high-level LLV (HLLV) ranging from 400 to 999 copies/mL. LLV occurrence frequency was divided into two groups: intermittent LLV (iLLV) was defined as one independent LLV with both the previous and the subsequent viral load below the lower limit of detection. Persistent LLV (pLLV) was defined as at least two consecutive episodes of LLV. We divided the people living with HIV/AIDS into two sub-cohorts based on whether they experienced LLV. Non-LLV was defined as never having experienced LLV. We compared the occurrence of LLV at different levels and frequencies, as well as the risk of virological failure (VF), using the Chi-square test. Non-conditional binary logistic regression analysis was used to identify factors influencing LLV.ResultsIn total, 28,613 cases of infection were analyzed, with 33.72% (9,649/28,613) exhibiting LLV. The LLV proportion rates were 20.69, 6.50, and 6.48% in the low-level LLV (LLLV) (50–199 copies/mL), medium-level LLV (MLLV) (200–399 copies/mL), and high-level LLV (HLLV) (400–999 copies/mL) groups, respectively. The intermittent LLV (iLLV) and persistent LLV (pLLV) groups had LLV rates of 28.65 and 5.07%, respectively. The VF rates were 6.18, 11.79, and 13.70% in the LLLV, MLLV, and HLLV groups, respectively (p < 0.001). The iLLV and pLLV groups had VF rates of 8.82 and 8.14%, respectively (p = 0.397). Multivariate logistic regression analysis revealed that the gender, ethnicity, age at antiretroviral therapy initiation, baseline CD4+ T lymphocyte count, and current treatment regimen were factors influencing the occurrence of LLV.ConclusionThe incidence of LLV among people living with HIV/AIDS treated with INSTI-sparing regimens in Guizhou Province is relatively high and is mainly influenced by factors such as age, CD4+ T lymphocyte count and treatment regimens. A comprehensive assessment of these factors is essential to implement targeted interventions that prevent LLV and enhance the effectiveness of antiretroviral therapy.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1535285/fullAIDSantiretroviral therapyepidemiological characteristicsGuizhou Provinceinfluencing factorslow-level viremia |
| spellingShingle | Yan Zheng Xinling Zha Hai Long Wenji Zeng Junhua Wang Yongming Yao Lu Huang Xiaotian Song Maosi Wang Yang Chen Yang Chen Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China Frontiers in Public Health AIDS antiretroviral therapy epidemiological characteristics Guizhou Province influencing factors low-level viremia |
| title | Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China |
| title_full | Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China |
| title_fullStr | Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China |
| title_full_unstemmed | Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China |
| title_short | Prevalence of low-level viremia in people living with HIV/AIDS and its impact on virological failure in Guizhou Province, China |
| title_sort | prevalence of low level viremia in people living with hiv aids and its impact on virological failure in guizhou province china |
| topic | AIDS antiretroviral therapy epidemiological characteristics Guizhou Province influencing factors low-level viremia |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1535285/full |
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