Nigeria CDC/Nigeria Field Epidemiology and Laboratory Training Programme 2^nd Annual Scientific Conference (Abuja, 2017)

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 Mar 2018.
doi: 10.11604/pamj-cp.2018.8.18.600

Archived on: 21 Mar 2018

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Keywords: Antiretroviral therapy, HIV, viral load, Nigeria

Opening ceremony

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

Izuchukwu Frank Obi^1,2,&, Babatunde Adedokun³, Okechukwu Ossai⁴, Chinwe Chukwuka², Kabir Sabitu^1,5, 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.