Factors associated with viral suppression and rebound among adult HIV patients on treatment: a retrospective study in Ghana.
Antiretroviral therapy (ART)
HIV/AIDS
Viral rebound
Viral suppression
Journal
AIDS research and therapy
ISSN: 1742-6405
Titre abrégé: AIDS Res Ther
Pays: England
ID NLM: 101237921
Informations de publication
Date de publication:
25 05 2022
25 05 2022
Historique:
received:
04
04
2022
accepted:
04
05
2022
entrez:
25
5
2022
pubmed:
26
5
2022
medline:
28
5
2022
Statut:
epublish
Résumé
Viral suppression remains the most desired outcome in the management of patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and this can be achieved by an effective Antiretroviral Therapy (ART). However, some patients who achieve viral suppression may experience viral rebound with dire consequence. We evaluated viral suppression and rebound and their associated factors among adult patients on ART in Kumasi, Ghana. This hospital-based retrospective study was conducted at the Komfo Anokye Teaching Hospital in Ghana. We reviewed the medical records of 720 HIV patients on ART. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism version 8.0. p < 0.05 was considered statistically significant. Proportions of patients with viral suppression and viral rebound were 76.1% and 21.0% respectively. Being diagnosed at WHO stage I [aOR = 11.40, 95% CI (3.54-36.74), p < 0.0001], having good adherence to ART [aOR = 5.09, 95% CI (2.67-9.73), p < 0.0001], taking Nevirapine-based regimen [aOR = 4.66, 95% CI (1.20-18.04), p = 0.0260] and increasing duration of treatment (p < 0.0001) were independently associated with higher odds of viral suppression. However, being diagnosed at WHO stage II (aOR = 7.39, 95% CI 2.67-20.51; p < 0.0001) and stage III (aOR = 8.62, 95% CI 3.16-23.50; p < 0.0001), having poor adherence (aOR = 175.48, 95% CI 44.30-695.07; p < 0.0001), recording baseline suppression value of 20-49 copies/mL (aOR = 6.43, 95% CI 2.72-15.17; p < 0.0001) and being treated with Zidovudine/Lamivudine/Efavirenz (aOR = 6.49, 95% CI 1.85-22.79; p = 0.004) and Zidovudine/Lamivudine/Nevirapine (aOR = 18.68, 95% CI 1.58-220.90; p = 0.02) were independently associated with higher odds of viral rebound. Approximately 76% viral suppression rate among HIV patients on ART in Kumasi falls below the WHO 95% target by the year 2030. Choice of ART combination, drug adherence, WHO clinical staging and baseline viral load are factors associated with suppression or rebound. These clinical characteristics of HIV patients must be monitored concurrently with the viral load.
Sections du résumé
BACKGROUND
Viral suppression remains the most desired outcome in the management of patients with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) and this can be achieved by an effective Antiretroviral Therapy (ART). However, some patients who achieve viral suppression may experience viral rebound with dire consequence. We evaluated viral suppression and rebound and their associated factors among adult patients on ART in Kumasi, Ghana.
METHODS
This hospital-based retrospective study was conducted at the Komfo Anokye Teaching Hospital in Ghana. We reviewed the medical records of 720 HIV patients on ART. Statistical analyses were performed using SPSS Version 26.0 and GraphPad prism version 8.0. p < 0.05 was considered statistically significant.
RESULTS
Proportions of patients with viral suppression and viral rebound were 76.1% and 21.0% respectively. Being diagnosed at WHO stage I [aOR = 11.40, 95% CI (3.54-36.74), p < 0.0001], having good adherence to ART [aOR = 5.09, 95% CI (2.67-9.73), p < 0.0001], taking Nevirapine-based regimen [aOR = 4.66, 95% CI (1.20-18.04), p = 0.0260] and increasing duration of treatment (p < 0.0001) were independently associated with higher odds of viral suppression. However, being diagnosed at WHO stage II (aOR = 7.39, 95% CI 2.67-20.51; p < 0.0001) and stage III (aOR = 8.62, 95% CI 3.16-23.50; p < 0.0001), having poor adherence (aOR = 175.48, 95% CI 44.30-695.07; p < 0.0001), recording baseline suppression value of 20-49 copies/mL (aOR = 6.43, 95% CI 2.72-15.17; p < 0.0001) and being treated with Zidovudine/Lamivudine/Efavirenz (aOR = 6.49, 95% CI 1.85-22.79; p = 0.004) and Zidovudine/Lamivudine/Nevirapine (aOR = 18.68, 95% CI 1.58-220.90; p = 0.02) were independently associated with higher odds of viral rebound.
CONCLUSION
Approximately 76% viral suppression rate among HIV patients on ART in Kumasi falls below the WHO 95% target by the year 2030. Choice of ART combination, drug adherence, WHO clinical staging and baseline viral load are factors associated with suppression or rebound. These clinical characteristics of HIV patients must be monitored concurrently with the viral load.
Identifiants
pubmed: 35614510
doi: 10.1186/s12981-022-00447-2
pii: 10.1186/s12981-022-00447-2
pmc: PMC9131580
doi:
Substances chimiques
Anti-HIV Agents
0
Lamivudine
2T8Q726O95
Zidovudine
4B9XT59T7S
Nevirapine
99DK7FVK1H
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
21Informations de copyright
© 2022. The Author(s).
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