Characteristics and viral suppression among people living with HIV from the National Free Antiretroviral Therapy Programme, 2019.

Abstract

This study aimed to present the clinical characteristics of and viral suppression in the national antiretroviral therapy (ART) cohort in China. A cross-sectional study was conducted among the participants enrolled in China's National Free Antiretroviral Therapy Programme (NFATP) who were on ART at the end of 2019. The data used were from China's NFATP information system. The primary outcome was viral load (VL) suppression. Full virological suppression and low-level viraemia (LLV) were defined as VL<50copies/mL and between 51 and 999copies/mL, respectively. At the end of 2019, 853429 people living with HIV (PLWH) were on ART. The median age was 44years [interquartile range (IQR): 33-54]. The majority of PLWH were 25-44years old (47.2%) and male (73.5%) and reported HIV infection via heterosexual contact (64.5%). The median (IQR) baseline CD4 count was 257 (140-376) cells/μL. Among the 704375 PLWH who were on ART for at least 12months, 82.9% had full virological suppression, 6.5% had VL between 50 and 1000copies/mL (LLV) and 4.3% had VL > 1000copies/mL. Optimal full virological suppression occurred in participants who acquired HIV through homosexual contact (88.4%). Although China can be credited for substantial progress in scaling up ART and viral suppression, challenges remain in some key populations, such as injecting drug users, participants with a history of treatment failure and hepatitis C virus co-infected people. To improve the programme output, additional monitoring and intervention for LLV are necessary.