Factors Associated with the Unsuppressed Viral Load of Children on Antiretroviral Therapy Followed Up in the Gb&amp;#234;k&amp;#234; Region (C&amp;#244;te d’Ivoire)

Tanoh-Aka Aude Hélène,Sahi Landryse,Siallou-Avi Christelle,Adou Leïoh Roméo,Yao Kouassi Christian,Asse Kouadio Vincent,Yeboua Kossonou Roland,Amani Alexise,Tuo Wako Tianwa Alice,Gawa Kokora Junior

doi:10.4236/ojped.2021.114067

Abstract

Introduction: Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death. The aim of the study was to identify factors associated with unsuppressed viral load in children on ART for the improvement of prognosis. Patients and Methods: this is a retrospective, descriptive and analytical study carried out from July 2015 to December 2019 in the 28 pediatric HIV/AIDS treatment centers supervised by the NGO IRAA in the region of Gbêkê. It Included children from 0 to 15 years who were HIV positive, on ART for at least 6 months with at least one viral load. The variables studied were socio-demographic, diagnostic and evolutionary. Data analysis was descriptive and analytical with a significance level of p Results: out of 329 children included, 118 (62 boys, 53 girls) had a non-suppressed VL, i.e. a prevalence of 36%. The mean age at diagnosis was 61 months. The mother was a small trader (36.4%), illiterate (45.8%). Unsuppressed viral load was significantly associated with poor nutritional status at the start of treatment (p Conclusion: Unsuppressed viral load is common in children on ART in the Gbêkê region. It mainly concerns the child who did not comply with ART, and whose mother was not followed within the framework of PMTCT. Strengthening early detection, early initiation of ART, PMTCT and increased therapeutic education strategies would improve the prognosis of children infected with HIV.

Highlights

Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death
In the Gbêkê region, Asse et al [7] reported in 2019 in the pediatric department of the University Hospital of Bouaké that 38.3% of children followed in the context of prevent mother-to-child transmission of HIV (PMTCT) had an unsuppressed viral load, but without specifying the significant factors associated with this condition
We studied the following variables: 1) the socio-demographic characteristics of the child and of the parents, 2) the child’s HIV parameters at diagnosis (Prevention of Mother-to-Child Transmission in the mother, age at diagnosis, place and date of diagnosis, cotrimoxazole prophylaxis, opportunistic infections, type of HIV, CDC clinical stage, CD4 count, viral load, place of care, date of initiation of treatment and ART regimen, weight and height), 3) evolution at visits of M3, M6, M12 (CD4 count, viral load, compliance education, CDC clinical stage, weight, height, opportunistic infections, cotrimoxazole prophylaxis, compliance and outcome)

Summary

Introduction

Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death. Patients and Methods: this is a retrospective, descriptive and analytical study carried out from July 2015 to December 2019 in the 28 pediatric HIV/AIDS treatment centers supervised by the NGO IRAA in the region of Gbêkê It Included children from 0 to 15 years who were HIV positive, on ART for at least 6 months with at least one viral load. In the Gbêkê region, Asse et al [7] reported in 2019 in the pediatric department of the University Hospital of Bouaké that 38.3% of children followed in the context of PMTCT had an unsuppressed viral load, but without specifying the significant factors associated with this condition.

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