Virological Non-Suppression Among HIV-Positive Patients on Antiretroviral Therapy in Northwestern Nigeria: An Eleven-Year Experience of A Tertiary Care Centre, January 2009–December 2019

Abstract

\n Background: Human Immuno-Deficiency Virus (HIV) remains one of the world’s significant public health challenges. Viral suppression is the key indicator for treatment success in People living with HIV (PLHIV). We determined the level of viral non-suppression and its associated factors among PLHIV attending Federal Medical Centre Katsina (FMC Katsina), Nigeria. Methods: This retrospective descriptive study was conducted on 913 HIV positive adults enrolled in care between January 2009 and December 2019. Information on socio-demographics, clinical, immunological, Viral Load (VL) and other relevant parameters were extracted from the patients’ care Centre Katsina estimated frequencies/proportions, performed bivariate and multivariate analysis to determine factors associated with VL non-suppression using p<0.05 as significant level. Results: Records of 831 registered patients were analyzed using Epi-info 7. During the period, 751 (90.4%) achieved viral suppression, 426 (51.3%) had CD4 counts of ≥500 and 477 (57.4%) were on HAART for ≥5 years. Majority, 793 (95.4%) were on first-line and 809 (97.4%) in the non-advanced stage (WHO stages 1 and 2). The independent predictors of viral non-suppression included being on the second line HAART [Adjusted OR (AOR) 6.5; 95% CI 3.02-13.89], being employed [AOR 0.26; 95% CI 0.15-0.44] and baseline CD4 count less than 500 [AOR 0.35; 95% CI 0.21-0.61]. Conclusions: Our study demonstrated a good viral suppression among PLHIV on HAART. Low baseline CD4 counts and being on second-line HAART are predictive of viral non-suppression while being unemployed seems to be protective against viral non-suppression.