Community viral load – an optimal alternative index of population viral load for HIV/AIDS surveillance

Abstract

ObjectiveTo explore an optimal alternative index of population viral load (PVL) suitable for assessing potential human immunodeficiency virus (HIV) transmission in the population of Yining city, Xinjiang Uygur Autonomous Region. Methods All previously and newly diagnosed HIV/AIDS cases aged ≥ 13 years were recruited into a dynamic cohort in Yining city from 2017 through 2019. Questionnaire interviews and viral load (VL) monitoring were conducted among all the HIV/AIDS cases. Based on the data collected, PVL, monitored viral load (MVL), in-care viral load (ICVL), aware viral load (AVL), and community viral load (CVL) were calculated and viremia prevalence, HIV infection incidence, antiretroviral therapy (ART) coverage, and viral inhibition rate were estimated. Correlations among the indicators were assessed. ResultsAll values of PVL, MVL, ICVL, and AVL decreased significantly during the 3-year period (all P 400 copies/m: r = 0.997, P = 0.048 and for VL > 1 000 copies/mL: r = 0.998, P = 0.041) but inversely with ART coverage (r = – 1.000, P = 0.019 and r = – 1.000, P = 0.012) and virus suppression rate (r = – 1.000, P = 0.010 and r = – 1.000, P = 0.003). ConclusionCVL is the most optimal alternative index of PVL and could be adopted together with viremia prevalence rate in assessment on potential HIV transmission intensity.

Keywords

• hiv/aids
• population viral load
• community viral load
• viremia prevalence
• new infection rate