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Incidence of low-level viremia and its impact on virologic failure among people living with HIV who started an integrase strand transfer inhibitors: a longitudinal cohort study.
Lao, Xiaojie; Zhang, Hanxi; Deng, Meiju; Li, Qun; Xiao, Qing; He, Lin; Ma, Liying; Song, Aqian; Liang, Xuelei; Yu, Fengting; Zhao, Hongxin; Zhang, Fujie.
Afiliação
  • Lao X; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Zhang H; WHO Collaborating Centre for Comprehensive Management of HIV Treatment and Care, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Deng M; Clinical Center for HIV/AIDS, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Li Q; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Xiao Q; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • He L; State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
  • Ma L; State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
  • Song A; Department of Gastroenterology, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Liang X; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Yu F; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Zhao H; Clinical Center for HIV/AIDS, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China.
  • Zhang F; Department of Infectious Disease, Beijing Ditan Hospital Capital Medical University, Beijing, 100015, China. treatment@chinaaids.cn.
BMC Infect Dis ; 24(1): 8, 2024 Jan 02.
Article em En | MEDLINE | ID: mdl-38166689
ABSTRACT

BACKGROUND:

Low-level viremia (LLV) has been identified as a potential precursor to virologic failure (VF), yet its clinical implications, particularly within the context of Integrase Strand Transfer Inhibitors (INSTIs)-based regimens, remain insufficiently explored. The study aimed to investigate the relationship between LLV and VF within ART-naïve patients on INSTIs-based regimens in China.

METHODS:

A longitudinal cohort study was conducted with ART-naïve patients aged ≥ 18 years at Beijing Ditan Hospital, under the Chinese National Free Antiretroviral Treatment Program (NFATP). The LLV was defined as a viral load (VL) ranging from 50 to 199 copies/mL after six months of ART initiation, and VF as a VL ≥ 200 copies/mL. Sensitive analyses were also performed, defining LLV as 50-999 copies/mL and VF as exceeding 1000 copies/mL. Multivariate logistic regression, Kaplan-Meier (KM) curve, and Generalized Estimating Equation (GEE) models were used to evaluate the risk factors associated with LLV and VF events.

RESULTS:

The study involved 830 ART-naïve patients, comprising 600 in the INSTIs group and 230 in the protease inhibitors (PIs) group. LLV events were observed in 10.4% of patients on PIs-based regimens and and 3.2% on INSTIs-based regimens (P < 0.001). INSTIs-based regimens demonstrated a protective effect against LLV events (aHR = 0.27, 95% CI 0.137-0.532). VF events occurred in 10.9% of patients on PIs-based regimens and 2.0% on INSTIs-based regimens, respectively (P < 0.001). The occurrence of LLV events significantly increased the risk of VF by 123.5% (95% CI 7.5%-364.4%), while the integrase inhibitors were associated with a 76.9% (95% CI 59.1%-86.9%) reduction in VF risk.

CONCLUSION:

Our findings indicate that INSTIs-based regimens are critical protective factors against LLV and subsequent VF. These results underscore the importance of HIV viral load monitoring to ensuring effective treatment outcomes, highlighting the necessity for prompt and precise monitoring to refine HIV treatment methodologies.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Infect Dis Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 2_ODS3 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: BMC Infect Dis Ano de publicação: 2024 Tipo de documento: Article