Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China
Abstract Background Understanding the current status of low-level viremia (LLV) is necessary for controlling the spread of HIV globally. However, the existing data on LLV prevalence during antiretroviral therapy (ART) and LLV risk contributing to subsequent virologic failure (VF) is still scant in C...
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BMC
2025-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-11395-3 |
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| author | Yuting Tan Wu Zheng Songjie Wu Dingyuan Zhao Yanmeng Feng Shi Zou Qianhui Chen Jie Liu Heng Tang Ke Liang |
| author_facet | Yuting Tan Wu Zheng Songjie Wu Dingyuan Zhao Yanmeng Feng Shi Zou Qianhui Chen Jie Liu Heng Tang Ke Liang |
| author_sort | Yuting Tan |
| collection | DOAJ |
| description | Abstract Background Understanding the current status of low-level viremia (LLV) is necessary for controlling the spread of HIV globally. However, the existing data on LLV prevalence during antiretroviral therapy (ART) and LLV risk contributing to subsequent virologic failure (VF) is still scant in China. Methods A large sample size, retrospective cohort study was conducted in Hubei province, China between January 1, 2011 and October 30, 2023. The LLV incidence was evaluated according to the first viral load of each year. The risk factors associated with LLV and subsequent VF among people living with HIV (PLWH) were accessed. Results Totally, 25,607 PLWH managed by Hubei province Center for Disease Control and Prevention were screened, and 19,930 PLWH were eligible for the study. Of them, 18,052 received the first line ART, 1103 received the second line ART, and 963 received the third line ART. 2497 (13.8%) PLWH on first line, 189 (17.1%) PLWH on second line and 100 (10.4%) PLWH on third line ART experienced LLV, respectively.The LLV level between 51 and 199 copies/ml was the most common in both three groups. CD4 count < 200 cells/µL and older age at ART initiation were associated with higher risk of LLV among all PLWH and PLWH receiving the first line ART, and protease inhibitors (PIs) using was associated with the higher risk of LLV among all PLWH. Both LLV level among 51–199, 200–399 and 400–999 copies/mL were risk factors leading to VF occurrence. Conclusions Close surveillance of HIV-VL is imperative among PLWH with CD4 count < 200 cells/µL, older age and PIs use for avoiding LLV occurrence. Clinical strategies should be strengthened among PLWH with LLV, given the increased vulnerability to subsequent VF. |
| format | Article |
| id | doaj-art-c0faa87dfe5940e1a5c427e8336e0eb6 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-c0faa87dfe5940e1a5c427e8336e0eb62025-08-20T03:04:20ZengBMCBMC Infectious Diseases1471-23342025-08-0125111010.1186/s12879-025-11395-3Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in ChinaYuting Tan0Wu Zheng1Songjie Wu2Dingyuan Zhao3Yanmeng Feng4Shi Zou5Qianhui Chen6Jie Liu7Heng Tang8Ke Liang9Department of Infectious Diseases, Zhongnan Hospital of Wuhan UniversityHubei province Center for Disease Control and PreventionDepartment of Nosocomial Infection Management, Zhongnan Hospital of Wuhan UniversityHubei province Center for Disease Control and PreventionHubei province Center for Disease Control and PreventionDepartment of Infectious Diseases, Zhongnan Hospital of Wuhan UniversityDepartment of Infectious Diseases, Zhongnan Hospital of Wuhan UniversityDepartment of Infectious Diseases, Zhongnan Hospital of Wuhan UniversityHubei province Center for Disease Control and PreventionDepartment of Infectious Diseases, Zhongnan Hospital of Wuhan UniversityAbstract Background Understanding the current status of low-level viremia (LLV) is necessary for controlling the spread of HIV globally. However, the existing data on LLV prevalence during antiretroviral therapy (ART) and LLV risk contributing to subsequent virologic failure (VF) is still scant in China. Methods A large sample size, retrospective cohort study was conducted in Hubei province, China between January 1, 2011 and October 30, 2023. The LLV incidence was evaluated according to the first viral load of each year. The risk factors associated with LLV and subsequent VF among people living with HIV (PLWH) were accessed. Results Totally, 25,607 PLWH managed by Hubei province Center for Disease Control and Prevention were screened, and 19,930 PLWH were eligible for the study. Of them, 18,052 received the first line ART, 1103 received the second line ART, and 963 received the third line ART. 2497 (13.8%) PLWH on first line, 189 (17.1%) PLWH on second line and 100 (10.4%) PLWH on third line ART experienced LLV, respectively.The LLV level between 51 and 199 copies/ml was the most common in both three groups. CD4 count < 200 cells/µL and older age at ART initiation were associated with higher risk of LLV among all PLWH and PLWH receiving the first line ART, and protease inhibitors (PIs) using was associated with the higher risk of LLV among all PLWH. Both LLV level among 51–199, 200–399 and 400–999 copies/mL were risk factors leading to VF occurrence. Conclusions Close surveillance of HIV-VL is imperative among PLWH with CD4 count < 200 cells/µL, older age and PIs use for avoiding LLV occurrence. Clinical strategies should be strengthened among PLWH with LLV, given the increased vulnerability to subsequent VF.https://doi.org/10.1186/s12879-025-11395-3HIVARTPrevalenceLow-level viremiaVirologic failureRisk factor |
| spellingShingle | Yuting Tan Wu Zheng Songjie Wu Dingyuan Zhao Yanmeng Feng Shi Zou Qianhui Chen Jie Liu Heng Tang Ke Liang Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China BMC Infectious Diseases HIV ART Prevalence Low-level viremia Virologic failure Risk factor |
| title | Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China |
| title_full | Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China |
| title_fullStr | Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China |
| title_full_unstemmed | Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China |
| title_short | Low-level viremia and subsequent virologic failure among people living with HIV: a retrospective cohort study in China |
| title_sort | low level viremia and subsequent virologic failure among people living with hiv a retrospective cohort study in china |
| topic | HIV ART Prevalence Low-level viremia Virologic failure Risk factor |
| url | https://doi.org/10.1186/s12879-025-11395-3 |
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