Objective: To explore the association between the effectiveness of antiretroviral therapy (ART) and major chronic diseases or death among HIV-infected patients in Taizhou, Zhejiang Province in 1998-2023. Methods: The data were collected from Chinese Disease Prevention and Control Information System and Taizhou Chronic Disease Information Management System. The subjects were HIV-infected patients with household registration in Taizhou from 1998 to 2023, who received ART for ≥6 months and underwent viral load testing ≥2 times. Logistic regression models were used to analyze the association between ART effectiveness and major chronic diseases or death. Results: A total of 2 918 HIV-infected patients were included, with virological suppression, low-level viremia, and virological failure accounting for 86.15% (2 514/2 918), 9.12% (266/2 918), and 4.73% (138/2 918), respectively. The incidence of major chronic diseases and case fatality rate among HIV-infected patients were 11.00% (321/2 918) and 6.58% (192/2 918), respectively. The incidence of major chronic disease in patients with virologic suppression and virological failure, as well as the fatality rate across different ART effectiveness groups, all showed an increasing trend with age (all P<0.05). After adjusting for potential confounders, compared with virologically suppressed patients, those with virological failure had a higher risk of death (aOR=2.15, 95%CI: 1.14-4.04). Age-stratified analysis revealed that in the <50 years old group, patients with low-level viremia had a higher risk of developing major chronic disease (aOR=2.15, 95%CI: 1.20-3.87). Conclusions: The low-level viremia was associated with major chronic diseases in young and middle-aged HIV-infected patients in Taizhou, Zhejiang Province, from 1998 to 2023. For young and middle-aged HIV-infected patients with suboptimal ART responses in follow-up management, regular chronic disease screening and health management are also indicated. 目的： 探讨1998-2023年浙江省台州市HIV感染者抗病毒治疗（ART）效果与主要慢性病合并症及死亡的关联。 方法： 资料来源于中国疾病预防控制信息系统和台州市慢性病信息管理系统，研究对象为1998-2023年户籍地为台州市、接受ART≥6个月且病毒载量检测≥2次的HIV感染者，采用logistic回归模型分析ART效果与主要慢性病合并症及死亡的关联。 结果： 纳入2 918例HIV感染者，其中病毒学抑制、低病毒血症和病毒学失败分别占86.15%（2 514/2 918）、9.12%（266/2 918）和4.73%（138/2 918）。HIV感染者主要慢性病合并症发病率为11.00%（321/2 918），病死率为6.58%（192/2 918）。病毒学抑制和病毒学失败者的主要慢性病合并症发病率、不同ART效果的病死率出现随年龄增长而上升的趋势（均P<0.05）。调整潜在的混杂因素后，与病毒学抑制者相比，病毒学失败者的死亡风险更高（aOR=2.15，95%CI：1.14~4.04）。年龄分层后发现，在<50岁年龄组中，低病毒血症者的主要慢性病合并症的发生风险更高（aOR=2.15，95%CI：1.20~3.87）。 结论： 1998-2023年浙江省台州市青壮年HIV感染者的低病毒血症与主要慢性病合并症存在关联。在随访管理中，针对ART效果不佳的青壮年HIV感染者应定期开展慢性病筛查和健康管理。.
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