Birhanu Waju1, Lamessa Dube2, Muktar Ahmed2,3, Semira Shimeles Assefa4. 1. ICAP Ethiopia HIV Prevention, Care and Treatment Program, Addis Ababa, Ethiopia. 2. Jimma University, Department of Epidemiology, Jimma, Ethiopia. 3. Australian Centre for Precision Health, Adelaide, SA, Australia. 4. Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia.
Abstract
BACKGROUND: Unsuppressed viral load in patients on antiretroviral (ARV) therapy occurs when treatment fails to suppress a patient's viral load, and is associated with decreased survival and increased HIV transmission. Identifying the level of unsuppressed viral load with its associated factors has benefits in controlling transmission and reducing burden. Therefore, this study aimed to assess unsuppressed viral load (>1,000 copies/mL) and associated factors among HIV patients taking first-line antiretroviral treatment at public health facilities in Jimma, Ethiopia. METHODS: A facility-based cross-sectional study was conducted on 669 patients on first-line ARV therapy (at least 6 months) in public health facilities in Jimma. Sociodemographic, treatment, clinical, immunological, and viral load data were extracted from medical records, entered into EpiData 3.1, and analyzed with SPSS 20. Multivariate logistic regression analysis was performed to identify factors independently associated with viral nonsuppression, considering a 95% CI with P<0.05 statistically significant. RESULTS: Among the participants, 258 (38.6%) were aged 25-34 years. Median age was 35 years. Prevalence of unsuppressed viral load was 20.3%. Risk of unsuppressed viral loads was 91% lower among ARV therapy patients who had been taking ARV therapy <2 years (AOR 0.09, 95% CI 0.01-0.83), lower baseline BMI (AOR 4.44, 95% CI 1.56-12.64), lower baseline CD4 (AOR 2.76, 95% CI 1.45-5.29), poor adherence to ARV therapy medication (AOR 3.19, 95% CI 1.29-7.89), and immunological failure (AOR 4.26, 95% CI 2.56-7.09) were the independent predictors of unsuppressed viral load. CONCLUSION: This study revealed that there is a high level of virological failure among adult HIV patients, and confirms the need to develop close follow-up strategies of targeted interventions for patients in care who are at high risk of unsuppressed viral load.
BACKGROUND: Unsuppressed viral load in patients on antiretroviral (ARV) therapy occurs when treatment fails to suppress a patient's viral load, and is associated with decreased survival and increased HIV transmission. Identifying the level of unsuppressed viral load with its associated factors has benefits in controlling transmission and reducing burden. Therefore, this study aimed to assess unsuppressed viral load (>1,000 copies/mL) and associated factors among HIV patients taking first-line antiretroviral treatment at public health facilities in Jimma, Ethiopia. METHODS: A facility-based cross-sectional study was conducted on 669 patients on first-line ARV therapy (at least 6 months) in public health facilities in Jimma. Sociodemographic, treatment, clinical, immunological, and viral load data were extracted from medical records, entered into EpiData 3.1, and analyzed with SPSS 20. Multivariate logistic regression analysis was performed to identify factors independently associated with viral nonsuppression, considering a 95% CI with P<0.05 statistically significant. RESULTS: Among the participants, 258 (38.6%) were aged 25-34 years. Median age was 35 years. Prevalence of unsuppressed viral load was 20.3%. Risk of unsuppressed viral loads was 91% lower among ARV therapy patients who had been taking ARV therapy <2 years (AOR 0.09, 95% CI 0.01-0.83), lower baseline BMI (AOR 4.44, 95% CI 1.56-12.64), lower baseline CD4 (AOR 2.76, 95% CI 1.45-5.29), poor adherence to ARV therapy medication (AOR 3.19, 95% CI 1.29-7.89), and immunological failure (AOR 4.26, 95% CI 2.56-7.09) were the independent predictors of unsuppressed viral load. CONCLUSION: This study revealed that there is a high level of virological failure among adult HIV patients, and confirms the need to develop close follow-up strategies of targeted interventions for patients in care who are at high risk of unsuppressed viral load.
Authors: Jennifer N Sayles; Jacqueline Rurangirwa; Min Kim; Janni Kinsler; Rangell Oruga; Mike Janson Journal: AIDS Patient Care STDS Date: 2012-07-09 Impact factor: 5.078
Authors: Brenda Crabtree-Ramírez; Angelina Villasís-Keever; Arturo Galindo-Fraga; Carlos del Río; Juan Sierra-Madero Journal: AIDS Res Hum Retroviruses Date: 2010-04 Impact factor: 2.205
Authors: Moupali Das; Priscilla Lee Chu; Glenn-Milo Santos; Susan Scheer; Eric Vittinghoff; Willi McFarland; Grant N Colfax Journal: PLoS One Date: 2010-06-10 Impact factor: 3.240
Authors: Lisa J Nelson; Michael Beusenberg; Vincent Habiyambere; Nathan Shaffer; Marco A Vitoria; Raul Gonzalez Montero; Philippa J Easterbrook; Meg C Doherty Journal: AIDS Date: 2014-03 Impact factor: 4.177
Authors: John Stover; Lori Bollinger; Jose Antonio Izazola; Luiz Loures; Paul DeLay; Peter D Ghys Journal: PLoS One Date: 2016-05-09 Impact factor: 3.240
Authors: Frantz Jean Louis; Josiane Buteau; Kesner François; Erin Hulland; Jean Wysler Domerçant; Chunfu Yang; Jacques Boncy; Robert Burris; Valerie Pelletier; Nicholas Wagar; Varough Deyde; David W Lowrance; Macarthur Charles Journal: PLoS One Date: 2018-01-30 Impact factor: 3.240
Authors: Adenike O Soogun; Ayesha B M Kharsany; Temesgen Zewotir; Delia North; Ebenezer Ogunsakin; Perry Rakgoale Journal: Trop Med Infect Dis Date: 2022-09-06