Abstract | BACKGROUND: Children living with human immunodeficiency virus ( HIV) infection require lifelong effective antiretroviral therapy (ART). The goal of ART in HIV-infected persons is sustained viral suppression. There is limited information on virological non-suppression or failure and its associated factors in children in resource limited countries, particularly Ghana. METHODS: A cross-sectional study of 250 children aged 8 months to 15 years who had been on ART for at least 6 months attending the Paediatric HIV clinic at Korle Bu Teaching hospital in Ghana was performed. Socio-demographic, clinical, laboratory and ART Adherence related data were collected using questionnaires as well as medical records review. Blood samples were obtained for viral load and CD4+ count determination. Viral load levels > 1000 copies/ml on ART was considered virological non-suppression. Logistic regression was used to identify factors associated with virological non-suppression. RESULTS: The mean (±SD) age of the study participants was 11.4 ± 2.4 years and the proportion of males was 53.2%. Of the 250 study participants, 96 (38.4%) had virological non-suppression. After adjustment for significant variables, the factors associated with non-suppressed viral load were female gender (AOR 2.51 [95% CI 1.04-6.07], p = 0.041), having a previous history of treatment of tuberculosis (AOR 4.95 [95% CI 1.58-15.5], p = 0.006), severe CD4 immune suppression status at study recruitment (AOR 24.93 [95% CI 4.92-126.31], p < 0.001) and being on a nevirapine (NVP) based regimen (AOR 7.93 [95% CI 1.58-1.15], p = 0.005). CONCLUSION: The prevelance of virological non-suppression was high. Virological non-suppression was associated with a previous history of TB treatment, female gender, severe CD4 immune suppression status at study recruitment and being on a NVP based regimen. Early initiation of ART and phasing out NVP-based regimen might improve viral load suppression in children. In addition, children with a history of TB may need focused measures to maximize virological suppression.
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Authors | Adwoa K A Afrane, Bamenla Q Goka, Lorna Renner, Alfred E Yawson, Yakubu Alhassan, Seth N Owiafe, Seth Agyeman, Kwamena W C Sagoe, Awewura Kwara |
Journal | BMC infectious diseases
(BMC Infect Dis)
Vol. 21
Issue 1
Pg. 731
(Aug 02 2021)
ISSN: 1471-2334 [Electronic] England |
PMID | 34340689
(Publication Type: Journal Article)
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Copyright | © 2021. The Author(s). |
Chemical References |
- Anti-HIV Agents
- Nevirapine
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Topics |
- Adolescent
- Anti-HIV Agents
(therapeutic use)
- CD4 Lymphocyte Count
- Child
- Child, Preschool
- Cross-Sectional Studies
- Female
- Ghana
- HIV
(isolation & purification)
- HIV Infections
(complications, drug therapy, virology)
- Humans
- Infant
- Logistic Models
- Male
- Nevirapine
(therapeutic use)
- Risk Factors
- Sex Factors
- Treatment Failure
- Tuberculosis
(complications)
- Viral Load
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