Persistent low-level HIV-1 RNA between 20 and 50 copies/mL in antiretroviral-treated patients: associated factors and virological outcome
Persistent low-level HIV-1 RNA between 20 and 50 copies/mL in antiretroviral-treated patients: associated factors and virological outcome
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DOI：
10.1093/jac/dks191
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发表时间：
2012-09-01
影响因子：
5.2
通讯作者：
Yeni, Patrick
中科院分区：
文献类型：
--
作者：
Charpentier, Charlotte;Landman, Roland;Yeni, Patrick
本研究的目的是确定在接受抑制性抗逆转录病毒治疗的HIV感染患者中持续低水平病毒血症（LLV）的相关因素，并评估这些患者的病毒学结局。LLV定义为在1年随访期间至少有两个HIV-1 RNA值在20和50拷贝/mL之间。我们比较了所有值20拷贝/mL（LLV）的患者和LLV（LLV）患者。在纳入研究前，“Oblip ratio”定义为（HIV-1 RNA值<50拷贝/mL的数量）/（HIV-1 RNA测定的数量）。在纳入的656例患者中，5.8例在LLV组。研究入选时CDC B/C期和研究期前较高的斑点比率是与LLV独立相关的唯一因素。在1年的随访中，LLV组和LLV组发生病毒学失败的患者比例没有差异，40例患者从LLV状态转变为LLV状态。LLV在我们的系列中并不常见，随访没有证据表明病毒学失败率高于完全抑制患者。LLV似乎是一种一过性现象，可能是由残留的持续病毒复制和/或病毒释放和/或较低值下病毒载量测定的准确度驱动的。
The aim of our study was to identify factors associated with persistent low-level viraemia (LLV) in HIV-infected patients under suppressive antiretroviral therapy and to assess the virological outcome of these patients.LLV was defined as at least two HIV-1 RNA values between 20 and 50 copies/mL during 1 year of follow-up. We compared patients with all values 20 copies/mL (LLV) and patients with LLV (LLV). The oblip ratio' was defined as (number of HIV-1 RNA values 50 copies/mL)/(number of HIV-1 RNA determinations) before study inclusion.Among the 656 patients included, 5.8 were in group LLV. CDC stage B/C at study inclusion and a higher blip ratio before the study period were the only factors independently associated with LLV. During the 1 year follow-up, the proportion of patients experiencing virological failure was not different between the LLV and LLV groups, and 40 of patients shifted from LLV to LLV status.LLV was infrequent in our series and the follow-up did not evidence a higher rate of virological failure than in fully suppressed patients. LLV seems to be a transient phenomenon that might be driven by residual ongoing viral replication and/or viral release and/or accuracy of viral load assay at lower values.