Conference abstract

Virologic response among HIV infected adults on antiretroviral therapy in a tertiary facility in Enugu, Nigeria, 2016

Pan African Medical Journal - Conference Proceedings. 2018:8(18).21 Dec 2018.
doi: 10.11604/pamj-cp.2018.8.18.600

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Keywords: Antiretroviral therapy, HIV, viral load, Nigeria
Opening ceremony

Virologic response among HIV infected adults on antiretroviral therapy in a tertiary facility in Enugu, Nigeria, 2016

Izuchukwu Frank Obi1,2,&, Babatunde Adedokun3, Okechukwu Ossai4, Chinwe Chukwuka2, Kabir Sabitu1,5, Patrick Nguku1

1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Antiretroviral Clinic University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria, 3Department of Epidemiology and Biostatistics, University of Ibadan, Nigeria State, Nigeria, 4Department of Public Health, Enugu State Ministry of Health, Enugu, Nigeria, 5Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

&Corresponding author
Izuchukwu Frank Obi, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria

Abstract

Introduction: early and sustained viral suppression with effective Antiretroviral Therapy (ART) has been linked to good clinical outcome in HIV-infected patients. Resource constraints limits pre-ART resistance testing to ensure potent customised ART in our environment. We assessed the virologic response to the first line ART regimen recommended by the national guideline.

Methods: we reviewed the records of 478 HIV infected adult patients initiated on ART in the facility between 2009 and 2014, who did not miss any drug pick-up or laboratory appointments during the first year on ART. Extracted data was analyzed with Epi Info 7. We determined the proportion of patients who achieved undetectable viraemia [viral load (VL) < 400 copies/ml] at 12 weeks and 24 weeks, compared this across different ART regimen and determined factors influencing early viral load suppression.

Results: a total of 478 patients were studied, 310 (64.8%) were females, 346 (72.4%) were 30-49 yrs old. While 332 (69.5%) patients achieved undetectable viraemia at 12 weeks of ART, 356 (74.5%) achieved it at 24 weeks. After 12 weeks on ART, 112 (74.7%) of 150 patients on Tenofovir/Emtricitabin/Efavirenz, 184 (67.1%) of the 274 on Zidovudin/Lamivudin/Nevirapin and 32 (66.3%) of the 49 patients on Tenofovir/Lamivudin+Nevirapin achieved undetectable viraemia (p = 0.13). Patient age, sex, marital status, baseline CD4 count, TB co-infection status, WHO clinical stage of disease and plasma viral load at ART initiation were not significantly associated with early viral load suppression.

Conclusion: there was persistence of detectable viraemia in about one third of patients after 24 weeks on recommended first-line ART in our setting. This could have implications for early virologic failure. Resistance testing prior to ART initiation is recommended. These three ART regimens have comparable effectiveness.