Factors Influencing Viral Load Non-suppression among People Living with HIV (PLHIV) in Borno State, Nigeria: A Case of Umaru Shehu Ultra-Modern Hospital

Background: The 2019 National AIDS Indicator and Impact Survey (NAIIS) report showed that the prevalence of HIV in North East Nigeria is 1.1%. Despite the increasing number of patients on ART in Nigeria, there is inadequate information about clients with virologic failure and its different determinants among PLHIVs enrolled into care in resource-limited and security challenged settings like Borno state.

Objectives: To evaluate the suppression rate and the associated factors for non-suppression of Viral Load (VL) at a HIV/AIDS comprehensive service delivery site in Borno State.

Methods: A case study conducted using routinely received Viral Load (VL) test results in Umaru Shehu Ultra-Modern Hospital, Borno State. Six (6) VL data from 402 patients on HIV anti-retroviral therapy (ART). Data collected using standard tools and Lafiya Information Management System (LAMIS) used for data extraction and STATA 14 used for analysis. Logistic regression was employed to identify various factors associated with viral Load non-suppression (virologic failure) in the selected facility in the State.

Results: From the 402 patients; 279 (69.40%) were females while the remaining 123(30.60%) were males. Overall virologic failure/non-suppression rate was 16.33%. 19.2% of the patients age 25-29 were virally unsuppressed. The odds of virologic failure decreased with age, with children aged 5-9 years (OR= 1.97, 95%CI = 0.02-169.913) and adults (OR= 3.33, 95%CI = 0.064-171.66) registering the highest odds. Last clinical stage (OR= 1.54, 95%CI = 0.499-4.76) and Body mass Index (OR= 1.4, 95%CI = 0.5-4.33) increased the odds of virologic failure.

Conclusions: Demographic, economic and clinical data study increased the odds of virologic failure. Second line and third line ART regimens were protective against virologic failure. The study recommends close monitoring and regular follow up on patients by the case managers/care givers/treatment supporter and intensified patients' adherence support for repeat testers after suspected failure of the drug.