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

Autor:	Waju B; ICAP Ethiopia HIV Prevention, Care and Treatment Program, Addis Ababa, Ethiopia., Dube L; Jimma University, Department of Epidemiology, Jimma, Ethiopia., Ahmed M; Jimma University, Department of Epidemiology, Jimma, Ethiopia.; Australian Centre for Precision Health, Adelaide, SA, Australia., Assefa SS; Department of Biomedical Sciences, Jimma University, Jimma, Ethiopia.
Jazyk:	angličtina
Zdroj:	HIV/AIDS (Auckland, N.Z.) [HIV AIDS (Auckl)] 2021 May 14; Vol. 13, pp. 513-526. Date of Electronic Publication: 2021 May 14 (Print Publication: 2021).
DOI:	10.2147/HIV.S304653
Abstrakt:	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. Competing Interests: The authors report no conflicts of interest for this work. (© 2021 Waju et al.)
Databáze:	MEDLINE
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