Magnitude of Unsuppressed HIV Viral Load at Amhara Public Health Institute Dessie Branch, Northeast Ethiopia

Abstract

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)/is the leading cause of global burden of disease. The main goal of antiretroviral treatment is to suppress the replication of the virus in the body. Suppressed viral replication facilitates restoration of the immune function and significantly reduces the risk of HIV transmission. Viral load testing is the most recommended method to diagnose and confirm antiretroviral treatment failure. Epidemiological data on viral suppression status are very important for program managers so as to implement successful treatment regimen and design the correct prevention strategy. Objective: The aim of this study was to determine the magnitude of unsuppressed HIV viral load from patients referred for HIV viral load testing at Amhara Public Health Institute Dessie Branch Regional Reference laboratory from January 1/2017 to January 1/2019. Methods: An institution based retrospective cross sectional study was conducted from January 1/2017 to January 1/2019. After obtaining permission from all concerned bodies, data were collected from the viral load request paper, viral load result registration book and from the viral load and early infant diagnosis (EID) data base using a standard checklist. Data were checked for completeness, entered and analyzed using Statistical Package for Social Sciences (SPSS) version 21 computer software. Descriptive statistics and logistic regression analysis were employed to examine the possible risk factors of unsuppressed viral load. P-value less than 0.05 were considered statistically significant. Result: A total of 32,778 participants were included in this study and their mean age was 36 years. About 63.5% participants were females and 36.5% were males. The overall magnitude of unsuppressed HIV viral load was 15.1%. Being male (AOR = 1.300, 95% CI: 1.213-1.392), lower age, WHO clinical stage IV (AOR 75.352; 95% CI 48.831-116.277) and participants with targeted repeat viral load test (AOR 23.131; 95% CI 18.249-29.318) were significantly associated with viral un-suppression status. On the other hand there was no statistically significant association between pregnancy status, poor adherence and age greater than 40 years with viral un-suppression. Conclusion: The viral suppression status in this study, 84.9% were low when compared with the UNAIDS 95% target to be achieved in 2030. Lower age, male gender, fair adherence, advanced WHO clinical stage and participants with targeted repeat viral load test were significantly associated with viral un-suppression status. Comprehensive close follow up and intensified targeted adherence support should be provided for lower aged ART users and for those first viral load test exceed 1000 copies/ml.