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已发表论文
低水平病毒血症的 HIV 患者病毒学失败相关危险因素：一项回顾性研究
Authors Yang K, Zhang W, Ruan H, Yan J, Qi S, Tan X, Ruan L
Received 8 August 2025
Accepted for publication 18 November 2025
Published 1 December 2025 Volume 2025:18 Pages 6257—6268
DOI https://doi.org/10.2147/IDR.S559296
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Chi H. Lee
Kai Yang,1,* Wenyuan Zhang,2,* Huijing Ruan,1,* Jisong Yan,3,4 Shixuan Qi,1 Xiaojian Tan,1 Lianguo Ruan1
1Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People’s Republic of China; 2Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China; 3National Center for Respiratory Diseases; State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lianguo Ruan, Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People’s Republic of China, Email 2020jy0004@hust.edu.cn
Introduction: The objective of the current investigation was to develop a clinical predictive model for virological treatment failure in HIV patients with low level viremia.
Methods: The study included 786 patients with HIV-associated low-level viremia (LLV). Using Lasso and multivariable logistic regression, we developed a predictive model from clinical and laboratory variables to identify significant predictors. This predictive model was presented as a nomogram and subsequently transformed into a scoring system. Following model construction, internal validation was performed to evaluate the model’s calibration capability and clinical utility.
Results: The final model incorporated five predictors (HLLV, NVP/3TC/AZT, WHO stage 1, ART delay, triglyceride) into a point-based scoring system. Using the Youden index, a threshold of 6 points was determined. The model demonstrated good performance, with training and internal validation AUCs of 0.762 and 0.759, respectively, and satisfactory calibration and diagnostic accuracy.
Conclusion: New scoring system predicts virological failure in low-level viremia, supporting early clinical intervention.
Keywords: HIV/AIDS, low-level viremia, virological failure, nomogram, predictive scoring system
1Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People’s Republic of China; 2Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China; 3National Center for Respiratory Diseases; State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 4Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lianguo Ruan, Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, 430023, People’s Republic of China, Email 2020jy0004@hust.edu.cn
Introduction: The objective of the current investigation was to develop a clinical predictive model for virological treatment failure in HIV patients with low level viremia.
Methods: The study included 786 patients with HIV-associated low-level viremia (LLV). Using Lasso and multivariable logistic regression, we developed a predictive model from clinical and laboratory variables to identify significant predictors. This predictive model was presented as a nomogram and subsequently transformed into a scoring system. Following model construction, internal validation was performed to evaluate the model’s calibration capability and clinical utility.
Results: The final model incorporated five predictors (HLLV, NVP/3TC/AZT, WHO stage 1, ART delay, triglyceride) into a point-based scoring system. Using the Youden index, a threshold of 6 points was determined. The model demonstrated good performance, with training and internal validation AUCs of 0.762 and 0.759, respectively, and satisfactory calibration and diagnostic accuracy.
Conclusion: New scoring system predicts virological failure in low-level viremia, supporting early clinical intervention.
Keywords: HIV/AIDS, low-level viremia, virological failure, nomogram, predictive scoring system