HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study

Abstract Background Despite the benefits of Antiretroviral Therapy (ART), there is a growing concern of treatment failure. This study aimed to assess viral non suppression rate and factors associated with HIV viral non suppression among adolescents and adults on ART in Northern Ethiopia. Methods A r...

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Main Authors: Abraham Aregay Desta, Tewolde Wubayehu Woldearegay, Nesredin Futwi, Gebrecherkos Teame Gebrehiwot, Goyitom Gebremedhn Gebru, Asfawosen Aregay Berhe, Hagos Godefay
Format: Article
Language:English
Published: BMC 2020-01-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-019-4732-6
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author Abraham Aregay Desta
Tewolde Wubayehu Woldearegay
Nesredin Futwi
Gebrecherkos Teame Gebrehiwot
Goyitom Gebremedhn Gebru
Asfawosen Aregay Berhe
Hagos Godefay
author_facet Abraham Aregay Desta
Tewolde Wubayehu Woldearegay
Nesredin Futwi
Gebrecherkos Teame Gebrehiwot
Goyitom Gebremedhn Gebru
Asfawosen Aregay Berhe
Hagos Godefay
author_sort Abraham Aregay Desta
collection DOAJ
description Abstract Background Despite the benefits of Antiretroviral Therapy (ART), there is a growing concern of treatment failure. This study aimed to assess viral non suppression rate and factors associated with HIV viral non suppression among adolescents and adults on ART in Northern Ethiopia. Methods A retrospective cross sectional study was done on 19,525 study subjects. All the data in the database of Tigray Health Research Institute was exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Generalized Estimating Equation (GEE) logistic regression was used for statistical modeling of viral non suppression. Results A total of 5153 (26.39%; 95%CI (25.77%, 27.02)) patients had no viral suppression despite being on ART. Being male (AOR = 1.27, 95% CI: 1.18, 1.37), 15–19 years of age (AOR = 4.86, 95%CI: 3.86, 6.12), patients from primary hospital (AOR = 1.26, 95%CI: 1.05, 1.52), WHO staging II (AOR = 1.31, 95%CI: 1.10, 1.54), poor ART adherence level (AOR = 2.56, 95%CI: 1.97, 3.33), fair ART adherence level (AOR = 1.61, 95%CI: 1.36, 1.90), baseline CD-4 count of < 200 cells/micro liter (AOR = 1.33, 95%CI: 1.14, 1.54), recent CD-4 count of < 200 cells/micro liter (AOR = 3.78, 95%CI: 3.34, 4.27), regimen types: 1c (AZT-3TC-NVP) (AOR = 1.32, 95%CI: 1.22, 1.44), 2 h (TDF-3TC-ATV/R) (AOR = 1.79, 95%CI: 1.27, 2.52) and declined immunological responses after ART initiation (AOR = 1.45, 95%CI: 1.30, 1.61) were significantly associated with viral non-suppression. Conclusions The virological non suppression was high which makes it less likely to achieve the third 90 UNAIDS target. Being male, patients with WHO staging II and poor ART adherence level were significantly associated with viral non suppression. Therefore, intensive adherence support and counseling should be provided. It is also a high time to determine the antiretroviral drugs resistance pattern given the fact that a large number of patients had virological non suppression.
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spelling doaj.art-4ce6d7ae713a4bb3940fdc899a72a2702022-12-21T21:30:50ZengBMCBMC Infectious Diseases1471-23342020-01-0120111010.1186/s12879-019-4732-6HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective studyAbraham Aregay Desta0Tewolde Wubayehu Woldearegay1Nesredin Futwi2Gebrecherkos Teame Gebrehiwot3Goyitom Gebremedhn Gebru4Asfawosen Aregay Berhe5Hagos Godefay6Tigray Health Research InstituteTigray Health Research InstituteTigray Health Research InstituteTigray Health Research InstituteTigray Health Research InstituteTigray Health Research InstituteTigray Regional Health BureauAbstract Background Despite the benefits of Antiretroviral Therapy (ART), there is a growing concern of treatment failure. This study aimed to assess viral non suppression rate and factors associated with HIV viral non suppression among adolescents and adults on ART in Northern Ethiopia. Methods A retrospective cross sectional study was done on 19,525 study subjects. All the data in the database of Tigray Health Research Institute was exported to Microsoft excel 2010 and then data verification and filtration were done before exporting to STATA 14.0 for analysis. Generalized Estimating Equation (GEE) logistic regression was used for statistical modeling of viral non suppression. Results A total of 5153 (26.39%; 95%CI (25.77%, 27.02)) patients had no viral suppression despite being on ART. Being male (AOR = 1.27, 95% CI: 1.18, 1.37), 15–19 years of age (AOR = 4.86, 95%CI: 3.86, 6.12), patients from primary hospital (AOR = 1.26, 95%CI: 1.05, 1.52), WHO staging II (AOR = 1.31, 95%CI: 1.10, 1.54), poor ART adherence level (AOR = 2.56, 95%CI: 1.97, 3.33), fair ART adherence level (AOR = 1.61, 95%CI: 1.36, 1.90), baseline CD-4 count of < 200 cells/micro liter (AOR = 1.33, 95%CI: 1.14, 1.54), recent CD-4 count of < 200 cells/micro liter (AOR = 3.78, 95%CI: 3.34, 4.27), regimen types: 1c (AZT-3TC-NVP) (AOR = 1.32, 95%CI: 1.22, 1.44), 2 h (TDF-3TC-ATV/R) (AOR = 1.79, 95%CI: 1.27, 2.52) and declined immunological responses after ART initiation (AOR = 1.45, 95%CI: 1.30, 1.61) were significantly associated with viral non-suppression. Conclusions The virological non suppression was high which makes it less likely to achieve the third 90 UNAIDS target. Being male, patients with WHO staging II and poor ART adherence level were significantly associated with viral non suppression. Therefore, intensive adherence support and counseling should be provided. It is also a high time to determine the antiretroviral drugs resistance pattern given the fact that a large number of patients had virological non suppression.https://doi.org/10.1186/s12879-019-4732-6Viral non suppressionViral suppressionViral loadHIVARTEthiopia
spellingShingle Abraham Aregay Desta
Tewolde Wubayehu Woldearegay
Nesredin Futwi
Gebrecherkos Teame Gebrehiwot
Goyitom Gebremedhn Gebru
Asfawosen Aregay Berhe
Hagos Godefay
HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
BMC Infectious Diseases
Viral non suppression
Viral suppression
Viral load
HIV
ART
Ethiopia
title HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
title_full HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
title_fullStr HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
title_full_unstemmed HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
title_short HIV virological non-suppression and factors associated with non-suppression among adolescents and adults on antiretroviral therapy in northern Ethiopia: a retrospective study
title_sort hiv virological non suppression and factors associated with non suppression among adolescents and adults on antiretroviral therapy in northern ethiopia a retrospective study
topic Viral non suppression
Viral suppression
Viral load
HIV
ART
Ethiopia
url https://doi.org/10.1186/s12879-019-4732-6
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