Study of the Factors that Influence Low-Level Viremias in Human Immunodeficiency Virus Patients in a Tertiary Hospital

Background Low-level viremias (LLVs) can be associated with age, suboptimal adherence, antiretroviral therapy (ART), and local epidemiology. The objective of the study was to analyze the influence of adherence and ART on the LLVs of human immunodeficiency virus patients in a tertiary hospital. Methods A descriptive, multidisciplinary, observational, and retrospective study of human immunodeficiency virus–naive patients who started ART between 2013 and 2018, who have not undergone changes in their ART, and who have been on treatment for at least 1 year was conducted. The following are the variables of the study: age, sex, ART, treatment start date, degree of adherence, and existence of LLVs. Results The sample included 153 patients (83.7% men) with a median age of 40 years (12–82 years). Of the patients who started with a nonnucleotide analog reverse-transcriptase inhibitor as the third drug, 26.8% (n = 56) presented with LLVs, 62.5% (n = 16) with an enhanced protease inhibitor (PI), and 42.7% (n = 75) with an integrase inhibitor. Fifty-seven patients (37.3%) presented with LLVs, with 48 (84.2%) having high adherence (≥90%). Statistically significant differences were observed in the presence of LLVs in patients who started with nonnucleotide analog reverse-transcriptase inhibitor as the third drug ( P = 0.025) and in those patients with PI as the third drug ( P = 0.047). In patients with LLVs, statistically significant differences were observed in the adherence of patients with PI ( P = 0.041). Conclusions A relationship was observed between low adherence, PI as the third drug, and LLVs. In patients with possible poor adherence to ART, a third drug with a high genetic barrier was used, but this did not prevent the presence of LLVs, making it necessary to use other strategies and closely monitor these patients.