Authors:
Michel LUHEMBWE
Journal:
BioMed
Content:
Abstract: Antiretroviral treatment (ART) has revolutionized the management of the human immunodeficiency
virus (HIV) and acquired immunodeficiency syndrome (AIDS), enabling long-term viral
load (VL) suppression in patients. Despite the proven effectiveness of ART, a significant proportion
of patients with HIV receiving ART fail to achieve viral load suppression (VLS). This study aimed to
identify factors associated with low VLS in the Tanganyika province. An unmatched case–control
study was conducted from January 2022 to June 2023, including 22 care facilities with viral load
data. Data were collected from patient records. For each reviewed record, the patient was invited
for an interview upon providing informed consent. Data were analyzed using SPSS version 27. In a
multivariable binary logistic regression model, variables with a p-value < 0.05 and a 95% confidence
interval for the adjusted odds ratio were considered significantly associated with unsuppressed VL.
A total of 462 individuals, including 156 cases and 306 controls, were included in the study. The
mean age (standard deviation) of participants was 42.12 (±11.6) years. The following covariates were
significantly associated with unsuppressed VL: poor HIV status disclosure to a confidant [adjusted
OR = 2.10, 95% CI (1.33–3.31), p = 0.001], poor ART adherence [adjusted OR = 2.01, 95% CI (1.25–3.23),
p = 0.004], ART interruption [adjusted OR = 3.43, 95% CI (2.00–5.88), p < 0.001], no participation in
support groups [adjusted OR = 2.16, 95% CI (1.25–3.71), p = 0.005], baseline WHO clinical stage 3
and 4 [adjusted OR = 2.24, 95% CI (1.32–3.79), p = 0.003], opportunistic infections (OIs) [adjusted
OR = 2.30, 95% CI (1.27–4.16), p = 0.006], and non-communicable chronic diseases (NCDs) [adjusted
OR = 2.30, 95% CI (1.10–4.79), p = 0.026]. Given the clear association between several factors and
unsuppressed VL, prevention should involve the implementation of innovative strategies targeting
at-risk patient groups. Strengthening the monitoring of these factors among active patients at each
appointment is recommended to achieve this goal.
Date:
2024-09-18
