Abstract: Objective To analyze the influencing factors of low-level viraemia (LLV) and its relationship with virus inhibition failure (VF) in HIV/AIDS patients undergoing antiretroviral therapy (ART) in Lu'an City, and to provide the evidence for the prevention of LLV. Methods A retrospective cohort study design was utilized, the ART database of the Lu'an City was obtained from the China Disease Control and Prevention Information System. HIV/AIDS patients who underwent ART, aged ≥16 years, and had an ART duration≥6 months between 2006 and 2023 were selected as the study subjects. Descriptive analysis was used to examine demographic characteristics and ART status, while a logistic regression model was employed to analyze the influencing factors of LLV. Additionally, a Kaplan-Meier survival curve was utilized to assess the association between LLV and VF. Results A total of 1 834 respondents were included in the analysis. The incidence of LLV was found to be 24.21% (444 cases), comprising 15.87% (291 cases) with low-level LLV (LLLV), 4.20% (77 cases) with medium-level LLV (MLLV), and 4.14% (76 cases) with high-level LLV (HLLV). There was a statistically significant difference in the incidence of VF for LLVs at different levels (P<0.05). The influencing factors of LLV included the current treatment area (Jin'an District OR=3.017, Yeji District OR=3.075, Shucheng County OR=3.473), route of infection (homosexual transmission OR=0.382, heterosexual transmission OR=0.504), change in treatment scheme (OR=1.854), baseline CD4+T lymphocyte count<200/μL (OR=1.642), as well as treatment duration being 1-5 years (OR=0.660). Conclusions There is a high risk for LLV in HIV/AIDS patients in Lu'an City, which increases their risk for VF. The risk factors identified include baseline CD4+T lymphocyte count<200/μL, changing treatment schemes, among others. It is necessary to start ART as earlier as possible and improve the quality of treatment management of patients.

Key words: HIV/AIDS patients, Low-level viraemia, Virus inhibition failure, Influencing factor