1346. Viral Suppression Rates Among Children and Adolescents Living with HIV in Baringo County, Kenya

Abstract

Abstract Background Annually, 220,000 infants are infected with HIV globally. Kenya has 139,000 children living with HIV and among this, 78.9% know their HIV status, 93.2% are on ART and 67.1% are virally-suppressed. Achieving viral suppression is challenging in children and adolescents residing in resource limited settings. Contributing factors include variability in weight and anti-retroviral pharmacokinetics, pre-treatment drug resistance and poor palatability of drugs. Adolescents’ developmental stage does affect their psychosocial and emotional functions which can have an adverse effect on their health seeking behavior and adherence to ART care and treatment. The study objective was to determine the viral suppression rates among children and adolescents in Baringo county Kenya for the period 2016-2020. Methods This was a cross sectional study where retrospective data was analyzed. The study sites were Baringo County hospital (BCRH) and Marigat sub-county hospital comprehensive care clinics (CCC). Electronic medical records of children and adolescents currently enrolled in care were retrieved from the Kenya EMR system. Data collected included demographics, clinical and laboratory data. Descriptive analysis was carried out. Results A total of 54 cases were retrieved. Mean age was 8.5 years (SD=5.4), males being 15/29 (52%). Majority, 51/54(94%) had WHO Stage 1 classification, while 4/54 (7.4%) had TB co-infection. The most widely-used treatment regimen was ABC/3TC/LPV/r 19/54 (35%). Regarding viral suppression status, 31/54(57%) were suppressed 10/54; (18.5%) had virologic failure and 13/45 (24%) had missing viral load tests. Majority, 45/53(85%) were retained in care; 4/53(7.5%) lost to follow up and 1/53 (2%) having died. Conclusion Viral-suppression was low with significant TB-HIV co-infection while retention to care was good. We recommend intensification of TB screening and improved viral load monitoring rates in this age-cohort. Treatment plans need to be designed to meet the clients’ specific needs. Community ART groups should be optimized and treatment peer champions engaged to support drug distribution and psychosocial support. Learning institutions should be involved in addressing barriers in accessing treatment by school-going children. Disclosures All Authors: No reported disclosures.