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| Factors affecting low-level viremia among HIV/AIDS cases after antiretroviral therapy |
| ZHU Tingting, LI Jun, CHEN Xiangyang, HU Wenxue, WANG Juejin, LIN Xiandan
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| Wenzhou Center for Disease Control and Prevention (Wenzhou Institute of Public Health Superision), Wenzhou, Zhejiang 325000, China |
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Abstract Objective To investigate the incidence of low-level viremia (LLV) among HIV/AIDS patients after antiretroviral therapy, and its influencing factors, so as to provide the evidence for early optimization of antiretroviral therapy strategies. Methods Data on HIV/AIDS cases receiving antiretroviral therapy at designated medical institutions in Wenzhou City, Zhejiang Province from 2004 to 2025 were collected through the Surveillance System of China Information System for Disease Control and Prevention, including demographic information, treatment information, and viral load. The start of antiretroviral therapy was set as the observation baseline, and the observation endpoint was the first occurrence of LLV, death, or the end of follow-up (May 31, 2025). The incidence of LLV was analyzed. Factors affecting LLV among HIV/AIDS cases were analyzed using a multivariable logistic regression model. Results A total of 5 939 HIV/AIDS cases were included. The predominant age group at confirmation was 25-<50 years, with 3 147 cases (52.99%). There were 4 775 males (80.40%) and 1 164 females (19.60%). As of May 31, 2025, 889 cases of LLV occurred, with an incidence of 14.97%. Multivariable logistic regression analysis showed that HIV/AIDS cases with household registration in Wenzhou City (OR=1.431, 95%CI: 1.165-1.757) and those with a first CD4+T lymphocyte count <350 cells/µL (<200 cells/µL, OR=1.572, 95%CI: 1.141-2.164; 200-<350 cells/µL, OR=1.450, 95%CI: 1.050-2.002) had a higher risk of LLV. Cases who started antiretroviral therapy between 2016 and 2025 (OR=0.027, 95%CI: 0.009-0.080), those with an interval from confirmation to antiretroviral therapy initiation <30 days (≤7 days, OR=0.432, 95%CI: 0.315-0.594; 8-<15 days, OR=0.584, 95%CI: 0.447-0.763; 15-<30 days, OR=0.641, 95%CI: 0.490-0.837), and those with a treatment duration ≥1 year (1 year, OR=0.206, 95%CI: 0.146-0.291; 2 years, OR=0.113, 95%CI: 0.079-0.162; 3 years, OR=0.071, 95%CI: 0.048-0.104; 4 years, OR=0.051, 95%CI: 0.034-0.075; 5 years, OR=0.042, 95%CI: 0.027-0.065; >5 years, OR=0.001, 95%CI: 0.001-0.002) had a lower risk of LLV. Conclusions The incidence of LLV among HIV/AIDS patients receiving antiretroviral therapy was 14.97%. The risk of LLV was mainly associated with household registration, first CD4+T lymphocyte count, year of antiretroviral therapy initiation, interval from confirmation to antiretroviral therapy initiation, and treatment duration.
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Received: 19 December 2025
Revised: 27 April 2026
Published: 22 June 2026
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