Viral Load Pattern of HIV Positive Children and Adolescents Attending a Paediatric Infectious Diseases Clinic in Owerri, Nigeria
Emeka Charles Nwolisa *
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
Udochukwuka Ikejiaku
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
Joseph Ezeogu
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
Kingsley Asinobi
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
Franklin Chime Emerenini
Paediatrics PMTCT LEAD, ICAP@Columbia University, Nigeria.
Kawa Alaoma
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
Emmanuel Ezenwa
Department of Paediatrics, Federal University Teaching Hospital, Owerri, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: The Viral load (VL) test measures the number of copies of HIV RNA in one milliliter of blood and is the preferred antiretroviral therapy (ART) monitoring strategy. Viral suppression is defined as patients having ≤ 1000 copies of viral RNA/ml of blood.
Methods/Materials: This study involved the retrospective review of viral load test result of patients aged 2-19years living with HIV/AIDS and enrolled in the treatment programme of the Paediatric infectious diseases clinic of the Federal University Teaching hospital Owerri.
Results: 117 patients met the inclusion criteria and 103 were virally suppressed giving a suppression rate of 88%. Majority of those virally suppressed were in the 15-19 age group. A logistic regression analysis to ascertain the impact of age, gender, drug regimen, and duration on ARTs on the likelihood of viral suppression showed that age, gender, and drug regimen were not significant predictors of viral suppression (p > 0.05). However, duration on ARTs was a significant predictor (p < 0.01), with patients who had been on ARTs for greater than 24 months having higher odds of viral suppression (OR = 5.42, 95% CI = 1.84-15.93) compared to those who had been on ARTs for 0-6 months.
Conclusion: Our study provides important insights into the viral load pattern of children and adolescents living with HIV/AIDS in Owerri. It highlights the importance of early initiation of ART, adherence to ART regimen, and routine viral load monitoring to achieve and maintain viral suppression.
Keywords: Viral load, viral suppression, children, adolescents
How to Cite
References
Available:https://www.who.int/news-room/fact-sheets/detail/hiv-aids. Accessed May 2023.
Available:https://www.childrenandaids.org/sites/default/files/2017-05/Nigeria-Integrated-National-Guildlines-For-HIV-Prevention-treatment-and-care-2014.pdf. Accessed May 2023.
Clinical guidelines: Antiretroviral therapy. Available:https://www.who.int/hiv/ pub/arv/chapter4.pdf. Accessed May 2023
World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Geneva; 2013.
Rawizza HE, Chaplin B, Meloni ST et al. Immunologic criteria are poor predictors of virologic outcome: Implications for HIV treatment monitoring in resource-limited settings. clinical infectious diseases. 2011;531283-1290.
UNAIDS Nigeria. start free, stay free, AIDS free. Available:https://www.unaids.org/en/resources/documents/2019/20190722_UNAIDS_SFSFAF_20192018. Accessed May 2023.
UNAIDS. Nigeria. HIV and AIDS Estimates .2019 Country Fact Sheet. Available:https://www.unaids.org/sites/default/files/country/documents/NGA_2020_countryreport.pdf. Accessed May 2003
Federal Ministry of Health. National implementation plan for scale-up of viral load testing in Nigeria. Federal Ministry of Health, Nigeria; 2016.
Nigeria HIV/AIDS indicator and impact survey. national summary sheet preliminary findings; 2019. Available:https://www.naiis.ng › resource › factsheet ›
World Health Organization. Antiretroviral Therapy (ART) coverage among all age groups. 2015.
Available:http://www.who.int/gho/hiv/epidemic_response/ART_text/en/. Accessed May 2023
Isaac EW, Ajani A, Iliya J, Christianah O and Hassan DM. HIV viral suppression in children in a subnational antiretroviral treatment programme in Nigeria. World Journal of AIDS. 2020:10;170-185.
Republic of Uganda. Central public health laboratories viral load dashboard; 2016.
Tchouwa GT, Duverny SE, Cournil A et al. Nationwide estimates of viral load suppression and acquired hiv drug resistance in Cameroon. E-Clinical Medicine. 2018;1:21-27.
Federal ministry of health. National guidelines for HIV prevention, treatment and Care; 2020.
Fokam J, Sosso SM, Yagai B, Billong SC, Djubgang Mbadie RE, Kamgaing Simo R et al. Viral suppression in adults, adolescents and children receiving Antiretroviral therapy in cameroon: Adolescents at High risk of virological failure in the era of test and treat. AIDS Research and Therapy. 2019:16;36.