目的：研究低水平病毒血症（LLV）的患病率及其与病毒学失败（VF）的关系。
方法：我们对YRGCARE的3498名参与者进行了回顾性分析，钦奈,印度（2013-2018）抗逆转录病毒治疗（ART）≥6个月，两次或两次以上血浆病毒载量（pVL）测量。对pVL<1000拷贝/mL的结果进行分层：完全抑制（FS）（pVL<40），低LLV（pVL40-199），mid-LLV(pVL200-399)，和高LLV（pVL400-999）。该研究使用Cox比例风险模型评估与VF(pVL>1000拷贝/mL)的关联。
结果：在3498名参与者中，2965例（84.8%）为FS，533例（15.2%）为LLV。在后续行动中,348（10%）有VF经验，其中222（6.3%）经历LLV（42%的LLV）和126（3.6%）经历FS（4.3%的FS）。与FS相比，LLV患者的VF风险更大[校正风险比(aHR)=12.7;95%置信区间(CI):10.2-15.9].一线参与者的VF发生率（aHR=15.8，95％CI：11.4-21.9）高于二线参与者（aHR=5.6，95％CI：4.1-7.7）。高LLV患者的VF风险最高（aHR=22.856，95％CI：15.204-34.359vs.aHR=8.186，95%CI：5.564-12.043，一线vs.二线参与者，分别)，其次是中LLV患者（aHR=13.375，95%CI：8.327-21.483与aHR=6.261，95%CI：4.044-9.695）和低LLV（aHR=12.976，95%CI：7.974-21.118vs.aHR=4.158，95%CI：2.826-6.119）。
结论：在我们的研究人群中，LLV的患病率处于中等水平。LLV患者的VF风险较高，这种风险随着LLV水平的增加而增加。密切监测经历LLV的个体可以帮助早期识别VF。
OBJECTIVE: To
study the prevalence of low-level viraemia (LLV) and its association with virological failure (VF).
METHODS: We conducted a retrospective analysis of 3498 participants at YRG CARE, Chennai, India (2013-2018) on antiretroviral therapy (ART) for ≥6 months with two or more plasma viral load (pVL) measurements. Results were stratified for those with pVL <1000 copies/mL: fully suppressed (FS) (pVL <40), low-LLV (pVL 40-199), mid-LLV (pVL 200-399), and high-LLV (pVL 400-999). The
study assessed the association with VF (pVL >1000 copies/mL) using Cox proportional hazard model.
RESULTS: Among 3498 participants, 2965 (84.8%) were FS and 533 (15.2%) were LLV. During the follow-up, 348 (10%) experienced VF, with 222 (6.3%) experienced after LLV (42% of LLV) and 126 (3.6%) experienced after FS (4.3% of FS). When compared with FS, those with LLV had a greater risk of VF [adjusted hazard ratio (aHR) = 12.7; 95% confidence interval (CI): 10.2-15.9]. First-line participants had a higher VF incidence (aHR = 15.8, 95% CI: 11.4-21.9) than second-line participants (aHR = 5.6, 95% CI: 4.1-7.7). Those with high-LLV had the highest VF risk (aHR = 22.856, 95% CI: 15.204-34.359 vs. aHR = 8.186, 95% CI: 5.564-12.043, for first-line vs. second-line participants, respectively), followed by those with mid-LLV (aHR = 13.375, 95% CI: 8.327-21.483 vs. aHR = 6.261, 95% CI: 4.044-9.695) and low-LLV (aHR = 12.976, 95% CI: 7.974-21.118 vs. aHR = 4.158, 95% CI: 2.826-6.119).
CONCLUSIONS: The prevalence of LLV was intermediate in our
study population. There was a higher risk of VF among individuals with LLV, and this risk increased with the increasing levels of LLV. Close monitoring of individuals experiencing LLV could help in the early identification of VF.
