Human Immunodeficiency Virus Viral Load Monitoring and Rate of Virologic Suppression Among Patients Receiving Antiretroviral Therapy in Democratic Republic of the Congo, 2013–2020

Abstract

Introduction ART expansion and viral load as a treatment monitoring approach have increased the demand for viral load testing. Many hurdles affect the coverage, quality and use of viral load results. Estimates of viral load monitoring and viral suppression rates are needed to assess the performance of ART programs and improve HIV management outcomes. Methods PLHIV viral load monitoring data were routinely collected in 84 health facilities in Kinshasa, DRC, between 2013 and 2020. The number of PLHIV under ART, the number of participants with at least one viral load test result, the rate of viral suppression (defined as ≤1,000 HIV RNA copies per mL), and the mean turnaround time from sample collection to release of viral load test results were collected together with clinical data. Results 14,057 PLHIV were included in the analysis. PLHIV were mainly enrolled after the “test and treat” implementation. The patients were followed for a median period of 27 months. The proportion of PLHIV with at least one available viral load largely increased in recent years. The delay from sample collection to release of viral load test results decreased overtime, from 35 days in 2018 to 16 days in 2020. Pregnancy and advanced HIV disease were associated with a lower chance of viral suppression. Conclusions There has been considerable success in increasing viral load access for all PLHIV under therapy in DRC. Nevertheless, viral load testing should be intensified with a particular effort to be made in groups at higher risk of viral failure.

A Retrospective Study on Virological Recovery Patterns and Factors Associated with HIV Viral Treatment Using Highly Active Anti-Retro viral Therapy in Public Health Facilities in Tigray, Northern Ethiopia

“…Female partners are more likely to achieve long-term virological recovery in HIV-positive individuals using HAART (4.24; 95% CI (2.97-6.03)). Research from South Africa and the Democratic Republic of the Congo indicates that female partners are more likely to achieve long-term virological recovery in HIV-positive individuals [25,26]. However, research from Ethiopia and South Africa contradicts our ndings [27,28].…”

Virological Non-Suppression among Newly Diagnosed HIV-Positive Individuals on Dolutegravir-Based Antiretroviral Treatment in Eastern Ethiopia: Follow-Up Study

“…In fact, many studies recommend the use of VL monitoring before and after ART initiation when a VL test is available [22]. The baseline VL test is the most important marker of initial assessment in patients with HIV at entry into care, because it determines the VL level of the patient, provides prognostic information about the probability of the disease progression, and monitors the efficacy of ART [23,24]. Evidence suggests that PLHIV with a high VL at the time of ART initiation have higher odds of treatment failure and early disease progression [20,23].…”