Yan Zheng ¹ Xinling Zha ² Hai Long ¹ Wenji Zeng ¹ Junhua Wang ² Yongming Yao ³ Lu Huang ³ Xiaotian Song ³ Maosi Wang ³ Yang Chen ^3*

• ¹ Guiyang Public Health Jiuzhi Center, Guiyang, Guizhou Province, China
• ² School of Public Health,the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education,Guizhou Medical University,Guiyang 561113,China, Guiyang, Guizhou Province, China
• ³ Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China

The frequency of low-level viremia (LLV) may differ within China. Therefore, this study aimed to analyze the epidemiological characteristics and factors influencing LLV among people living with HIV/AIDS in Guizhou Province from 2016 to 2022.In this retrospective cohort study, we analyzed people living with HIV/AIDS whose demographic data, CD4 + T lymphocyte count, and viral load. We divided the people living with HIV/AIDS into two sub-cohorts based on whether they experienced LLV.We compared the occurrence of LLV at different levels and frequencies, as well as the risk of virological failure (VF), using the Chi-square test. We also assessed the risk of death.Non-conditional binary logistic regression analysis was used to identify factors influencing LLV.In total, 28,613 cases of infection were analyzed, with 33.72% (9,649/28,613) exhibiting LLV. The LLV rates were 20.69%, 6.50%, and 6.48% in the low-level LLV (LLLV) (50-199 copies/mL), medium-level LLV (MLLV) (200-399 copies/mL), and high-level LLV (HLLV) (400-999 copies/mL) groups, respectively. The intermittent LLV (iLLV) and persistent LLV (pLLV) groups had LLV rates of 28.65% and 5.07%, respectively. The VF rates were 6.18%, 11.79%, and 13.70% in the LLLV, MLLV, and HLLV groups, respectively (P<0.001). The iLLV and pLLV groups had VF rates of 8.82% and 8.14%, respectively (P=0.397). Mortality was 7.83% in the LLV group and 7.04% in the non-LLV group, which was higher in the LLV group than in the non-LLV group (P=0.030). Multivariate logistic regression analysis revealed that the baseline World Health Organization clinical stage, age at antiretroviral therapy initiation, gender, marital status, ethnicity, baseline CD4 + T lymphocyte count, and initial treatment regimen were factors influencing the occurrence of LLV.The incidence of LLV in people living with HIV/AIDS in Guizhou Province was relatively high. Comprehensive consideration of various influencing factors should be undertaken to improve the antiretroviral treatment effect, adherence education, and quality of life.