Determinants of viral re-suppression among people living with HIV on second-line anti-retroviral therapy at a central hospital in Bulawayo, Zimbabwe
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Date
2024
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Universty of the Western Cape
Abstract
Background: The human immunodeficiency virus (HIV) pandemic has a staggering global impact, with two thirds of people living with HIV residing in sub-Saharan Africa. While virological failure (i.e. viral load (VL) >1000 RNA copies/ml) is well researched, few studies have investigated the determinants of viral re-suppression (VL<1000copies/ml) among clients on second-line anti-retroviral therapy (ART) regimens. It is necessary to analyse the factors associated with viral re-suppression among people living with HIV (PLHIV) on second-line ART because of the growing number of people who are taking second-line ART. Furthermore, studies indicate the scarcity of data on the efficacy of second-line ART in sub-Saharan Africa. This study aimed to determine the factors that are associated with viral re-suppression among individuals receiving second-line ART at a central hospital in Bulawayo, Zimbabwe. Methodology: A retrospective cohort study design was used where clinical records of 315 participants on a second-line ART regimen from 1 January 2015 to 31 December 2020 were reviewed. Selected clinical and demographic data were extracted from the records and examined against viral re-suppression and retention in care. A bi-variate analysis of the clinical and demographic factors (such as CD4 count and age respectively) was conducted by viral suppression and retention, followed by a multi-variate analysis of the significant factors concerning viral suppression and retention.
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Keywords
Viral re-suppression, Second-line, Retention in care, Viral load, Virological failure