Unsuppressed Viral Load Level in Public Health Facilities: Nonvirological Predictors among Adult Antiretroviral Therapy Users in Southwestern Ethiopia

Waju, Birhanu; Dube, Lamessa; Ahmed, Muktar Beshir; Assefa, Semira Shimeles

doi:10.2147/hiv.s304653

Cited by 20 publications

(27 citation statements)

References 25 publications

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“…This study is consistent with the study conducted in South Wollo zone of Ethiopia and Northern Ethiopia, Southwestern Ethiopia and Central part of Oromia in which lower CD4 count was significantly associated with viral suppression status [15,[20][21][22]. This implies that when CD4-count is very low, the immune system no longer strong enough to fight back infections and the viral load continuous to rise.…”

Section: Discussionsupporting

confidence: 91%

“…Intensive adherence support and counseling should conclusively be provided through effective implementation of ART programs by providers would enhance viral suppression ensuring the quality of care and treatment. Keywords: Unsuppressed viral load, Adherence, Case -control, Oromia treatment costs and loss of future options for treatment succession which puts the patient on an increased risk for drug toxicity from second-line regiment [15]. Late detection of treatment failure results in high frequencies of accumulated mutation and drug resistance.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies in public hospitals of Ethiopia indicate that lower CD4, lower Body mass index, Immunological failure, duration in month on ART and adherence associated with unsuppressed viral load. Drug resistance, anti-HIV medications poorly absorbed by the body, Side effect of the medications, other illnesses or conditions are the major impact on treatment success [15][16][17]. Hence, early detection of non-suppressed viral load is vital for management of the patients and monitoring of treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of unsuppressed viral load among adults on follow up of antiretroviral therapy at selected public and private health facilities of Adama town: unmached case-control study

et al. 2022

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Background Despite the scale up of antiretroviral therapy (ART), unsuppressed viral load among population taking ART in private and public health facilities is still a public health concern increasing the risk of treatment failure. Studies comprehensively assessing significant predictors of non-suppressed viral load among patients on follow up of AR in public and private health facilities are limited. The objective of the study was to identify predictors of unsuppressed viral load among adult patients taking antiretroviral therapy at selected public and private health facilities of Adama town, East shewa zone, Ethiopia. Methods An unmatched case-control study was conducted from April 15 /2021 to May 20/2021. A total sample size of 347 patients consisting 116 cases and 231 controls was selected from electronic database among patients who started ART from September 2015 to August 2020. Data were collected using checklist from patient medical records and analyzed by SPSS. The association of dependent and independent variables was determined using multivariate analysis with 95% confidence interval and P - value in logistic regression model to identify independent predictors. Result From the total 347 participants, 140 (40.3%) of them were males and 207 (59.7%) were females. In multivariate logistic regression, CD4 count < 100 [(AOR:1.22, 95% CI: 1.4-7.3)], CD4 100-200[(AOR: 2.58 95% CI: 1.06-8.28)], Fair Adherence [(AOR: 2.44, 95% CI: 1.67-4.82)], poor adherence [(AOR: 1.11, 95% CI: 1.7-6.73)], History of Cotrimoxazole Therapy (CPT) use and not used [(AOR: 2.60, 95% CI: 1.23-5.48)] and History of drug substitution [(AOR:. 361, 95% CI: .145-.897)] were independent predictors of unsuppressed viral load with the p-value less than 0.05. Conclusion and commendation In this study, Baseline CD4, adherence, History of CPT used and history of drug substitution was predictors of unsuppressed viral load. Monitoring immunological response through scheduled CD4 tests is essential to maintain immunity of the patients preventing diseases progression. Intensive adherence support and counseling should conclusively be provided through effective implementation of ART programs by providers would enhance viral suppression ensuring the quality of care and treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of unsuppressed viral load among adults on follow up of antiretroviral therapy at selected public and private health facilities of Adama town: unmached case-control study

et al. 2022

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“…This result confirms the conclusion by (Mwamburi et al, 2015) that Patients with HIV infection who are losing weight are likely not to virally suppress. Likewise, a study conducted in South-Western Ethiopia found that the odds of non-suppression were higher among those with low BMI (≤16-18.5kg/m2) (Waju et al, 2021). Similar studies conducted in Uganda and Tanzania also supported this current study since they reported that underweight HIV-positive adolescents were not virally suppressed compared to their counterparts with a normal weight {Council, 2011 #6}.…”

Section: The Associated Factors Of Viral Load Suppressionsupporting

confidence: 83%

Prevalence, Associated factors of Viral Load Suppression and Effect of Intensified Adherence Counselling among Adolescents on ART at Kisenyi, Kawala and Kitebi Health Centres. A Retrospective Chart Review.

Kansiime

Gwokyalya

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Background: Viral Load Suppression (VLS) is a product of awareness of a positive HIV diagnosis and adherence to ART. Adolescents on ART should virally suppress within six months of ART to live longer, boost their immune system and reduce chances of transmitting the HIV yet literature shows that adolescents are not virally suppressing as adults. The purpose of this study is to therefore assess the prevalence, associated factors of viral load suppression, and effect of intensified adherence counselling among adolescents on ART at Kisenyi, Kawala, and Kitebi Health Centers Methodology: The study utilized a retrospective chart review design. The study population included individual records of adolescents who had been on ART for at least six months from 1st January 2017 to 31st December 2020. Data were analyzed using both univariate and bivariate analysis to be able to describe the data and establish the associations between independent and dependent Variables. Results: The mean age of the 196 study respondents was 15 (SD 3.4). More than half (53%, N=103) of the respondents were aged 15-19 years while 47% (N=93) were aged between 10-14 years. The prevalence of viral load non-suppression after six months of ART was 36% (n-70), and sixty-nine percent (n-48) of the unsuppressed adolescents were females compared to males (31, n=22). Sixty-nine percent (47) of the unsuppressed adolescents were in primary school while 33% (n=23) of the Anglicans were virally unsuppressed. Recommendations: Health facilities should offer resistance testing to all unsuppressed adolescents before enrolment into the IAC program, IAC should be considered primarily for those adolescents identified to have adherence challenges without resistant mutant strains. Conclusion: it is also evident that not all adolescents who enroll in IAC program benefit from it as shown by the 38% of the adolescents who did not suppress following IAC.

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“…6 , 11 The rate of non-suppression of VL was different depending on the country, e.g. 15% in South Africa, 9.6% in Nigeria, 12 16% in Swaziland, 20% in Ethiopia, 13 29% in Uganda, 23.2% in Cambodia, 14.9% in Zimbabwe, and 27% in Los Angeles. Although VL testing has been important in following-up PLHIV, the above highlighted challenges have been identified worldwide in this strategy to the extent that it becomes difficult to determine early whether a person is suppressing or not, where challenges are still being faced.…”

Section: Introductionmentioning

confidence: 99%

The Frequency and Predictors of Unsuppressed HIV Viral Load Among People with HIV in Nyaruguru District, Rwanda

Hakizayezu¹,

Biracyaza²,

Niyompano³

et al. 2022

HIV

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Background By the end of 2015, epidemiological studies approximated 37 million people living with HIV (PLHIV) and 46.3% of them were initiated to antiretroviral therapies. From the 90-90-90 strategy, by 2020 at global level, 90% of all people living with HIV were expected to suppress viral load (VL). Although VL suppression is an important indicator of treatment success in PLHIV, studies on this indicator remain scarce in Rwanda where the prevalence of HIV is 3% with 9% for non-suppression. This work, thus, determined the prevalence of VL non-suppression and its associated predictors among PLHIV. Methods A cross-sectional study was conducted among 637 PLHIV enrolled in healthcare services between 2016 and 2017 in Nyaruguru district. Socio-demographic, treatment, clinical, immunological and VL data were extracted from medical records. Bivariate and multivariate logistic regression analyses were performed to determine associated factors with VL suppression considering 95% confidence intervals and statistical significance of p<0.005. Results More than half of participants were female (57.77%). The prevalence of unsuppressed HIV VL was 8.9% and 88.7% of respondents were satisfied with the service provided. Males were more likely to be unsuppressed HIV VL [aOR = 3.02; 95% CI (1.19–7.64), p = 0.02] than females. Higher likelihoods of VL non-suppression were among those with history of clinical failure [aOR = 3.14; 95% CI (1.70–14.03), p = 0.034] or history of treatment interruption [aOR = 8.29; 95% CI (2.60–26.42) p = 0.002]. Those with a bad perception toward the whole life treatment were more likely to be unsuppressed [aOR = 4.32; 95% CI (1.98–18.99), p = 0.049] than their counterparts. Conclusion Sex, treatment interruption, bad perception toward the whole life treatment, clinical failure and lack of confidentiality were the major predictors of being unsuppressed. More efforts on counseling HIV patients to improve their knowledge would drop levels of VL non-suppression, so improving the quality of service should be prioritized to increase suppression.

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Unsuppressed Viral Load Level in Public Health Facilities: Nonvirological Predictors among Adult Antiretroviral Therapy Users in Southwestern Ethiopia

Cited by 20 publications

References 25 publications

Predictors of unsuppressed viral load among adults on follow up of antiretroviral therapy at selected public and private health facilities of Adama town: unmached case-control study

Predictors of unsuppressed viral load among adults on follow up of antiretroviral therapy at selected public and private health facilities of Adama town: unmached case-control study

Prevalence, Associated factors of Viral Load Suppression and Effect of Intensified Adherence Counselling among Adolescents on ART at Kisenyi, Kawala and Kitebi Health Centres. A Retrospective Chart Review.

The Frequency and Predictors of Unsuppressed HIV Viral Load Among People with HIV in Nyaruguru District, Rwanda

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