【摘要】 目的 了解艾滋病病毒感染者和艾滋病患者(HIV/AIDS)接受抗病毒治疗后低病毒血症(LLV)发生情况及其影响因素，为早期优化抗病毒治疗策略提供依据。方法 通过中国疾病预防控制信息系统监测报告管理系统收集2004—2025年在浙江省温州市定点医疗机构接受抗病毒治疗的HIV/AIDS病例资料，包括人口学信息、治疗信息和病毒载量等资料。以HIV/AIDS病例开始抗病毒治疗为观察起点，以首次出现LLV、死亡或到随访截止时间(2025年5月31日)为观察终点，分析LLV发生率。采用多因素logistic回归模型分析HIV/AIDS病例LLV发生的影响因素。结果纳入HIV/AIDS病例5 939例，确证年龄以25～<50岁为主，3 147例占52.99%。男性4 775例，占80.40%；女性1 164例，占19.60%。截至2025年5月31日，发生LLV 889例，发生率为14.97%。多因素logistic回归分析结果显示，温州市户籍(OR=1.431,95%CI:1.165～1.757)、首次CD4~+T淋巴细胞计数<350个/??L(<200个/??L,OR=1.572,95%CI:1.141～2.164;200～<350个/??L,OR=1.450,95%CI:1.050～2.002)的HIV/AIDS病例LLV发生风险较高；2016—2025年开始抗病毒治疗(OR=0.027,95%CI:0.009～0.080)、确证至开始治疗时间间隔<30 d(≤7 d,OR=0.432,95%CI:0.315～0.594;8～<15 d,OR=0.584,95%CI:0.447～0.763;15～<30 d,OR=0.641,95%CI:0.490～0.837)和治疗年限≥1年(1年，OR=0.206,95%CI:0.146～0.291;2年，OR=0.113,95%CI:0.079～0.162;3年，OR=0.071,95%CI:0.048～0.104;4年，OR=0.051,95%CI:0.034～0.075;5年，OR=0.042,95%CI:0.027～0.065;>5年，OR=0.001,95%CI:0.001～0.002)的HIV/AIDS病例LLV发生风险较低。结论 抗病毒治疗HIV/AIDS病例LLV发生率为14.97%，发生风险主要与户籍、首次CD4~+T淋巴细胞计数、抗病毒治疗开始年份、确证至开始治疗时间间隔和治疗年限有关。更多还原

【Abstract】 Objective To investigate the incidence of low-level viremia(LLV) among HIV/AIDS patients after antiretroviral therapy, and its influencing factors, so as to provide the evidence for early optimization of antiretroviral therapy strategies. Methods Data on HIV/AIDS cases receiving antiretroviral therapy at designated medical institutions in Wenzhou City, Zhejiang Province from 2004 to 2025 were collected through the Surveillance System of China Information System for Disease Control and Prevention, including demographic information, treatment information, and viral load. The start of antiretroviral therapy was set as the observation baseline, and the observation endpoint was the first occurrence of LLV, death, or the end of follow-up(May 31, 2025). The incidence of LLV was analyzed. Factors affecting LLV among HIV/AIDS cases were analyzed using a multivariable logistic regression model. Results A total of 5 939 HIV/AIDS cases were included. The predominant age group at confirmation was 25-<50 years, with 3 147 cases(52.99%). There were 4 775 males(80.40%) and 1 164 females(19.60%). As of May 31, 2025, 889 cases of LLV occurred, with an incidence of 14.97%. Multivariable logistic regression analysis showed that HIV/AIDS cases with household registration in Wenzhou City(OR=1.431, 95%CI: 1.165-1.757) and those with a first CD4~+T lymphocyte count <350 cells/??L(<200 cells/??L, OR=1.572, 95%CI: 1.141-2.164; 200 – <350 cells/??L, OR=1.450, 95%CI: 1.050-2.002) had a higher risk of LLV. Cases who started antiretroviral therapy between 2016 and 2025(OR=0.027, 95%CI: 0.009-0.080), those with an interval from confirmation to antiretroviral therapy initiation <30 days(≤7 days, OR=0.432, 95%CI: 0.315-0.594; 8–<15 days, OR=0.584, 95%CI: 0.447-0.763; 15–<30 days, OR=0.641, 95%CI: 0.490-0.837), and those with a treatment duration ≥1 year(1 year, OR=0.206, 95%CI: 0.146-0.291; 2 years, OR=0.113, 95%CI: 0.079-0.162; 3 years,OR=0.071, 95%CI: 0.048-0.104; 4 years, OR=0.051, 95%CI: 0.034-0.075; 5 years, OR=0.042, 95%CI: 0.027-0.065; >5 years, OR=0.001, 95%CI: 0.001-0.002) had a lower risk of LLV. Conclusions The incidence of LLV among HIV/AIDS patients receiving antiretroviral therapy was 14.97%. The risk of LLV was mainly associated with household registration, first CD4~+T lymphocyte count, year of antiretroviral therapy initiation, interval from confirmation to antiretroviral therapy initiation, and treatment duration.更多还原