Determinants of viral load status among HIV positive children on ART at Zewditu Memorial Hospital, Addis Ababa: A case control study

Abstract

Introduction: Human Immunodeficiency Virus causes an immense amount of problems throughout the world, especially in sub-Saharan countries. Recently viral load is thought to be a good indicator in assessing HIV progression. Complementary feeding practice and type of complementary food are the major factors that affect VL Status. However, in Ethiopia there is paucity of evidence on the factors that could affect viral load among HIV exposed infants. Therefore, this study aimed to identify factors that affect VL Status among HIV positive children on ART at Zewditu Memorial Hospital (ZMH), Addis Ababa, Ethiopia using a case control study design. Methods: Institution based unmatched case- control study was employed among a total of 241 (71 cases and 170 controls) children attending for follow up in ZMH ART clinic from July to August 2020. The interviewer conducts a face-to-face interview for 24 hour’s dietary diversity from mothers using standardized and pre tested questioner. SPSS 20 was used for data entry and cleaning, while Stata 14 was used for data analysis. Backward stepwise logistic regression analysis was used to determine the association of the factors with the outcome variable. A P-value ≤ 0. 05 was considered statistically significant at 95% confidence level throughout the study. Result: Out of 241 children, 71 of them had high VL status, while the rest 170 of them had low VL status. Poor dietary diversity increases the risk of high VL on ART children [AOR= 4. 37, 95% CI: 2. 12-10. 71]. The risk of high VL increase on children whose mother’s marital status was single [AOR=4, 95% CI: 1. 40, 9. 70], among children who have a daily laborer mothers [AOR= 10. 6, 95% CI: 3. 20, 21. 67], and working on nongovernmental organizations [AOR=5. 32, 95% CI: 1. 68, 10. 51]. Children on WHO clinical stage 3 and 4 [AOR =15. 22, 95% CI: 4. 1, 39. 41], those children who started complementary feeding lately (after 6 months) [AOR= 4. 69, 95% CI: 2. 35, 13. 6] and children with poor Infant dietary diversity score [ AOR= 4. 37, 95% CI: 2. 12-10. 71]. Conclusion: Maternal marital status, maternal occupation, WHO clinical stage, late initiation of complementary feeding practice, and infant dietary diversity score are the factors affecting VL status in HIV positive children on ART at Zewditu memorial hospital.