Clinical-epidemiological profile and factors associated with viral non-suppression in patients living with HIV/AIDS assisted at the Integrated Treatment Center at the Maputo Military Hospital (CITRA/MMH), 2019 to 2020

Abstract

BackgroundHIV remains a critical global public health challenge. In 2022, it was estimated that approximately 39.0 million people worldwide were living with HIV, and of these, around 29.8 million were receiving antiretroviral therapy (ART). The objective was to evaluate the clinical and epidemiological profile and factors associated with viral load (VL) non-suppression in people living with HIV/AIDS at the Maputo Military Hospital (CITRA/MMH).MethodsA retrospective cross-sectional analytical study was conducted on 9105 people aged 15 years and over. We use secondary data from participants on ART for at least 2 years being followed up between the years 2019–2020 at CITRA/MMH. Those recently enrolled (on ART < 1 year) were excluded and data analysis was performed using STATA version 16. Pearson's chi-square test and logistic regression were used for statistical modeling of viral non-suppression with a 95%/CI confidence interval and p < 0.05.ResultsAmong a total of 9105 HIV participants included, 52.8% (n = 4808) were female and 13.6% (n = 1235) were military personnel. The average age was 47.9 years (standard deviation ± 12.1), with the most prevalent age group being individuals aged between 25 and 59, totalizing 7,297 (80.2%) participants. Only 5395 (100%) participants had VL results. Among these, 23.1% (n = 1247) had a result VL non-suppressed. Single marital status (Adjusted Odds Ratio [AOR] = 4.8, 95%CI: 3.93–5.76, p < 0.001), with active tuberculosis (AOR = 4.6, 95%CI: 3.15–6.63, p < 0.001) and current ART regimen in categories TDF + 3TC + EFV (AOR = 12.7, 95%CI: 9.74–16.63, p < 0.001), AZT + 3TC + NVP (AOR = 21.8, 95% CI: 14.13–33.59, p < 0.001) and “other” regimens (AOR = 25.8, 95%CI: 18.58–35.80, p < 0.001), when compared to the TDF + 3TC + DTG regime, were statistically significant for viral non- suppression.ConclusionThe study highlights the crucial role of ART adherence and ongoing monitoring to achieve viral suppression, particularly among adults aged 25 to 59. It underscores the need for transitioning eligible individuals to DTG-based regimens and addressing the implications of single marital status and comorbid conditions like active tuberculosis. The study emphasizes the importance of ARV adherence and continuous monitoring to meet the UNAIDS 95–95-95 targets and improve clinical outcomes for people living with HIV/AIDS.