关键词: China HIV antiretroviral therapy low-level viraemia viral suppression

Mesh : Adult Aged Anti-HIV Agents / therapeutic use Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count China / epidemiology Comorbidity Cross-Sectional Studies Drug Users / statistics & numerical data Female HIV Infections / drug therapy Hepatitis C / epidemiology Homosexuality, Female / statistics & numerical data Homosexuality, Male / statistics & numerical data Humans Male Middle Aged Treatment Outcome Young Adult

来  源:   DOI:10.1111/hiv.13020   PDF(Sci-hub)

Abstract:
This study aimed to present the clinical characteristics of and viral suppression in the national antiretroviral therapy (ART) cohort in China.
A cross-sectional study was conducted among the participants enrolled in China\'s National Free Antiretroviral Therapy Programme (NFATP) who were on ART at the end of 2019. The data used were from China\'s NFATP information system. The primary outcome was viral load (VL) suppression. Full virological suppression and low-level viraemia (LLV) were defined as VL < 50 copies/mL and between 51 and 999 copies/mL, respectively.
At the end of 2019, 853 429 people living with HIV (PLWH) were on ART. The median age was 44 years [interquartile range (IQR): 33-54]. The majority of PLWH were 25-44 years old (47.2%) and male (73.5%) and reported HIV infection via heterosexual contact (64.5%). The median (IQR) baseline CD4 count was 257 (140-376) cells/μL. Among the 704 375 PLWH who were on ART for at least 12 months, 82.9% had full virological suppression, 6.5% had VL between 50 and 1000 copies/mL (LLV) and 4.3% had VL > 1000 copies/mL. Optimal full virological suppression occurred in participants who acquired HIV through homosexual contact (88.4%).
Although China can be credited for substantial progress in scaling up ART and viral suppression, challenges remain in some key populations, such as injecting drug users, participants with a history of treatment failure and hepatitis C virus co-infected people. To improve the programme output, additional monitoring and intervention for LLV are necessary.
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