Risk Factors Associated with Virological Failure in HIV Patients with Low Level Viremia: A Retrospective Study

The objective of the current investigation was to develop a clinical predictive model for virological treatment failure in HIV patients with low level viremia.

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.

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.

New scoring system predicts virological failure in low-level viremia, supporting early clinical intervention.