1264. Characterization of HIV-Positive Patients with Low-Level Viremia in a Community HIV Clinic Between 2014 and 2018

BACKGROUND: Low-level viremia (LLV) has been defined as an HIV RNA level detectable by newer generation viral load quantification assays but that is ≤200 copies/mL.Contributing factors may include intermittent low-level releases of virus from existing reservoirs, random laboratory variation and decreased ART adherence. METHODS: This retrospective chart review aimed to characterize patients who developed LLV in a community HIV clinic between 2014 and 2018. LLV was defined as two consecutive detectable HIV RNA measurements ≤200 copies/mL. Possible factors that could be associated with viral rebound (VR), defined as an HIV RNA >200 copies/mL, were evaluated by using multivariate logistic regression. RESULTS: Of a total of 666 patients, 111 met criteria for LLV. Seventy-seven were male and 34 were female. The majority were African American (85.6%) with Hispanic and white accounting for 5.4% each. Fifty-five percent were heterosexual and 31.5% were men that have sex with men. Analyzing CD4 counts at the moment or just prior to the development of LLV, 42 of them (37.8%) had a CD4 between 501 and 800 cells/mm(3), 25 (22.5%) between 200 and 500 cells/mm3 and only 3.6% had CD4 counts <200 cells/mm(3). The majority (60.3%) were on integrase inhibitors (INSTI). Of the 111 patients, only 59 of them had at least 1-year follow-up post LLV. Those who were followed for less than 12 months post-LLV were not included in the statistical analysis to try and find potential factors associated with VR post LLV. Twelve (20.3%) of the 59 developed VR. HIV RNA levels between 51 and 100 copies/mL and 101 and 200 copies/mL were associated with higher odds of VR (OR 3.77 95% CI 0.37–38.77, 3.09 95% CI 0.27–35.88, respectively). Patients with STIs, heterosexuals and those on INSTI were also associated with higher odds of VR (OR 1.48 95% CI 0.12–18.5, 3.13 95% CI 0.75–13.03 and 1.61 95% CI 0.35–7.38, respectively). These results did not achieve statistical significance. CONCLUSION: This community HIV clinic has a low prevalence of LLV. Most of the patients did not develop VR. Although some clinical factors were found to be associated with viral rebound in patients with LLV, the associations did not achieve statistical significance. LLV is a phenomenon that requires further research, specifically regarding predictors of VR, particularly now in the INSTI era. DISCLOSURES: All authors: No reported disclosures.