PDF(Pubmed)
Abstract：
The World Health Organisation has implemented multiple HIV prevention policies and strived to achieve the 90-90-90 goal by 2020, achieving the 95-95-95 goal by 2030, which refers to 95% of patients living with HIV knowing their HIV status, 95% of patients living with HIV receiving continual care and medication, and 95% of patients living with HIV exhibiting viral suppression. However, how to measure the status of viral suppression varies, and it is hard to indicate the quality of HIV care. The study aimed to examine the long-term viral load suppression in these cases and explore potential factors affecting the control of long-term viral load.
This study analyzed viral load testing data from HIV patients who are still alive during the period from notification up to 2019-2020. Three indicators were calculated, including durable viral suppression, Viremia copy-years, and Viral load > 1,500 copies/ml, to assess the differences between them.
Among the 27,706 cases included in the study, the proportion of persistent viral load suppression was 87%, with 4% having viral loads exceeding 1,500 copies/ml. The average duration from notification to viral load suppression was 154 days, and the geometric mean of annual viral replication was 90 copies*years/ml. Regarding the last available viral load measurement, 96% of cases had an undetectable viral load. However, we observed that 9.3% of cases, while having an undetectable viral load for their last measurement, did not show consistent long-term viral load suppression. An analysis of factors associated with non-persistent viral load suppression revealed higher risk in younger age groups, individuals with an educational level of high school or below, injection drug users, cases from the eastern region, those seeking care at regional hospitals, cases with drug resistance data, individuals with lower healthcare continuity, and those with an initial CD4 count below 350 during the study period.
The recommendation is to combine it with the indicator of sustained viral load suppression for a more accurate assessment of the risk of HIV transmission within the infected community.
This study analyzed viral load testing data from HIV patients who are still alive during the period from notification up to 2019-2020. Three indicators were calculated, including durable viral suppression, Viremia copy-years, and Viral load > 1,500 copies/ml, to assess the differences between them.
Among the 27,706 cases included in the study, the proportion of persistent viral load suppression was 87%, with 4% having viral loads exceeding 1,500 copies/ml. The average duration from notification to viral load suppression was 154 days, and the geometric mean of annual viral replication was 90 copies*years/ml. Regarding the last available viral load measurement, 96% of cases had an undetectable viral load. However, we observed that 9.3% of cases, while having an undetectable viral load for their last measurement, did not show consistent long-term viral load suppression. An analysis of factors associated with non-persistent viral load suppression revealed higher risk in younger age groups, individuals with an educational level of high school or below, injection drug users, cases from the eastern region, those seeking care at regional hospitals, cases with drug resistance data, individuals with lower healthcare continuity, and those with an initial CD4 count below 350 during the study period.
The recommendation is to combine it with the indicator of sustained viral load suppression for a more accurate assessment of the risk of HIV transmission within the infected community.
摘要：
背景：世界卫生组织实施了多种艾滋病毒预防政策，并努力到2020年实现90-90-90目标，到2030年实现95-95-95目标，即95％的艾滋病毒感染者知道自己的艾滋病毒状况，95％的艾滋病毒感染者接受持续的护理和药物治疗，95％的HIV患者表现出病毒抑制。然而,如何测量病毒抑制的状态各不相同，很难指出艾滋病毒护理的质量。该研究旨在检查这些情况下的长期病毒载量抑制，并探索影响长期病毒载量控制的潜在因素。
方法：这项研究分析了从通知到2019-2020年期间仍然存活的HIV患者的病毒载量检测数据。计算了三个指标，包括持久的病毒抑制，病毒血症复制年，病毒载量>1,500拷贝/毫升，评估它们之间的差异。
结果：在纳入研究的27,706例中，持续病毒载量抑制的比例为87%，4％的病毒载量超过1,500拷贝/毫升。从通知到病毒载量抑制的平均持续时间为154天，病毒年复制的几何平均值为90拷贝*年/毫升。关于最后可用的病毒载量测量，96%的病例有检测不到的病毒载量。然而,我们观察到9.3%的病例，虽然他们最后一次测量有检测不到的病毒载量，没有显示一致的长期病毒载量抑制。与非持续性病毒载量抑制相关因素的分析显示，年轻年龄组的风险更高。具有高中或以下教育水平的个人，注射吸毒者，东部地区的病例，那些在地区医院寻求治疗的人，有耐药性数据的病例，医疗保健连续性较低的个人，以及在研究期间初始CD4计数低于350的患者。
结论：建议将其与持续病毒载量抑制指标相结合，以更准确地评估感染社区内HIV传播的风险。
方法：这项研究分析了从通知到2019-2020年期间仍然存活的HIV患者的病毒载量检测数据。计算了三个指标，包括持久的病毒抑制，病毒血症复制年，病毒载量>1,500拷贝/毫升，评估它们之间的差异。
结果：在纳入研究的27,706例中，持续病毒载量抑制的比例为87%，4％的病毒载量超过1,500拷贝/毫升。从通知到病毒载量抑制的平均持续时间为154天，病毒年复制的几何平均值为90拷贝*年/毫升。关于最后可用的病毒载量测量，96%的病例有检测不到的病毒载量。然而,我们观察到9.3%的病例，虽然他们最后一次测量有检测不到的病毒载量，没有显示一致的长期病毒载量抑制。与非持续性病毒载量抑制相关因素的分析显示，年轻年龄组的风险更高。具有高中或以下教育水平的个人，注射吸毒者，东部地区的病例，那些在地区医院寻求治疗的人，有耐药性数据的病例，医疗保健连续性较低的个人，以及在研究期间初始CD4计数低于350的患者。
结论：建议将其与持续病毒载量抑制指标相结合，以更准确地评估感染社区内HIV传播的风险。
