Despite availability of effective antiretroviral therapy (ART), many HIV patients still have a detectable viral load (VL). Predictive factors of detectable VL are not well documented. This study was done at two large multidisciplinary HIV outpatient clinics at the Centre hospitalier de l'Université de Montréal (CHUM) and the McGill University Health Centre (MUHC). This is a retrospective case–control study of patients treated between 2016 and 2018. Cases had a VL ≥50 copies/mL in 2018. Controls had an undetectable VL from 2016 to 2018. Matching was based on gender and year of HIV diagnosis. Primary objective was to identify predictive factors of detectable VL. Secondary objectives included to identify predictive factors of virologic failure, low persistent viremia, and viral blip. A forward stepwise model selection by the Akaike Information Criterion of the conditional logistic regression was used to identify predictive factors. Two hundred cases were identified and matched with 200 controls. The cohort was mostly male (68.0%) with a median age of 54 years (21–83 years). Among cases, viral blip was the most common type of detectable VL (43.0%). The strong predictive factors for a detectable VL were adherence to ART and seeking health care services. Asylum seekers were less at risk of detectable VL. Adherence to ART was the only strong predictive factor for virologic failure. Three main predictive factors of detectable VL were identified in two ambulatory clinic hospitals in Montreal. Ascertaining these factors will allow for identification of patients more at risk of detectable VL.

中文翻译：

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HIV感染患者可检测病毒载量的预测因素

尽管有有效的抗逆转录病毒疗法 (ART)，但许多 HIV 患者仍具有可检测的病毒载量 (VL)。可检测 VL 的预测因素没有得到很好的记录。这项研究是在蒙特利尔大学医院中心 (CHUM) 和麦吉尔大学健康中心 (MUHC) 的两个大型多学科 HIV 门诊诊所进行的。这是一项针对 2016 年至 2018 年期间接受治疗的患者的回顾性病例对照研究。2018 年病例的 VL ≥50 拷贝/mL。对照组在 2016 年至 2018 年期间检测不到 VL。匹配基于性别和 HIV 诊断年份。主要目标是确定可检测 VL 的预测因素。次要目标包括确定病毒学失败、低持续性病毒血症和病毒短暂性的预测因素。使用条件逻辑回归的 Akaike 信息标准的前向逐步模型选择来识别预测因素。确定了 200 个病例并与 200 个对照匹配。该队列主要为男性（68.0%），中位年龄为 54 岁（21-83 岁）。在病例中，病毒性斑点是最常见的可检测 VL 类型（43.0%）。可检测 VL 的强预测因素是坚持 ART 和寻求医疗保健服务。寻求庇护者感染 VL 的风险较小。ART 的依从性是病毒学失败的唯一强预测因素。在蒙特利尔的两家门诊医院确定了可检测到的 VL 的三个主要预测因素。确定这些因素将允许识别更有可能检测到 VL 的患者。