Trends in Viral Load Suppression among Adults on ART: A Five-Year Retrospective Study in North-central Nigeria

Abstract

Aim: The aim of this study was to determine the trends in viral load suppression among adults on ART: a five-year retrospective study in North central Nigeria, since Human Immunodeficiency Virus (HIV) has claimed the lives of many people globally and impacted negatively on the health care system especially in Nigeria. The viral load detection on HIV patient is a good standard for checking compliance and effectiveness of antiretroviral drugs. Purpose of the Study: The main purpose of this study was to determine the viral load suppression, clinical characteristics and factors associated with viral load suppression. Study Design:  A retrospective cross-sectional study Place and Duration of the Study: The study was carried out at Federal Medical Centre, Makurdi, Benue State, North Central-Nigeria from January 2020 to December 2024. Methodology: Data was collected based on Secondary data abstraction on all HIV positive patients attending clinic at sexually transmitted infectious clinic at Federal Medical centre Makurdi, North Centre Nigeria.  A total of 9727 HIV positive patients were retrieved and information on sociodemographic charactereristics, viral loads, clinical characteristics, duration of antiretroviral therapy, first CD4 counts and associated factors that favored viral load suppression were obtained and recorded. The data were analyzed using Statistical Package for the Social Science (SPSS) Version 23. Results: The results showed that age of patients ranges from 18years to above 65 years. The mean years was 46.69 + 10.89 years. However, the age ranges between 38-47years had the highest frequency of viral load suppression (38.7%). Also based on sex, female had better viral load suppression when compared to their male counterparts (70.8%). On educational qualification patients with secondary educational qualifications had better viral load suppression when compared to the other levels of educational qualifications (38.7%). Also, patients with first line regimen had their better viral load suppression when compared to those on second line (93.4%). Two thirds of the patients on antiretroviral therapy for at least ten years and above had more viral load suppression when compared to those less than ten years on ART (65%). About half of the patients who had first CD4 count <500 copies/ml, had better viral load suppression compared to those who had first CD4 count >500 copies/ml (52.5%). The highest prevalence of viral load suppression (100%) was seen in those patients aged 78 years and above, and was statistically significant (p<0.001). The female patients had higher prevalence (97.3%) of viral load suppression when compared to their male counterparts who had viral load suppression of 95.7%, which was statistically significant (p<0.001). Conclusion: The age, sex, first line regimen and duration on ART were identified as independent predictors of viral load suppression.