Risk factors and clinical prediction models for low-level viremia in people living with HIV receiving antiretroviral therapy: an 11-year retrospective study

作者：Wenhui Zhang, Jinchuan Shi, Ying Wang, Ying Wang, Er Li, Dingyan Yan, Zhongdong Zhang, Mingli Zhu, Jianhua Yu, Yi Wang, Yi Wang · 发表于：Frontiers in Microbiology · 年份：2024 · DOI：10.3389/fmicb.2024.1451201 · 被引用次数：8 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV-related health complications and treatments

Objective: This study explores the risk factors for low-level viremia (LLV) occurrence after ART and develops a risk prediction model. Method: Clinical data and laboratory indicators of people living with HIV (PLWH) at Hangzhou Xixi Hospital from 5 April 2011 to 29 December 2022 were collected. LASSO Cox regression and multivariate Cox regression analysis were performed to identify laboratory indicators and establish a nomogram for predicting LLV occurrence. The nomogram's discrimination and calibration were assessed via ROC curve and calibration plots. The concordance index (C-index) and decision curve analysis (DCA) were used to evaluate its effectiveness. Result: T-cell count (baseline CD4), baseline viral load (baseline VL), and total bilirubin (TBIL), were incorporated into the nomogram to develop a risk prediction model. The optimal model (which includes 6 variables) had an AUC for LLV after 1-year, 3-year, and 5-year of listing of 0.68 (95% CI, 0.61-0.69), 0.69 (95% CI, 0.65-0.70), and 0.70 (95% CI, 0.66-0.71), respectively. The calibration curve showed high consistency between predicted and actual observations. The C-index and DCA indicated superior prediction performance of the nomogram. There was a significant difference in CD4 levels between LLV and non-LLV groups during the follow-up time. The dynamic SCR, ALT, TG and BG levels and occurrence of complications differed significantly between the high- and low-risk groups. Conclusion: A simple-to-use nomogram contain...