Time to Viral Load Suppression and Its Associated Factors in Cohort of Patients Taking Antiretroviral Treatment in East Shewa Zone, Oromiya Region, Ethiopia, 2018

Abstract

Background: Human immuno-deficiency virus (HIV) is a virus that causes Acquired ImmunoDeficiency Syndrome (AIDS). The key goal of ART is to achieve and maintain durable viral suppression. Thus, the most important use of the viral load is to monitor the effectiveness of therapy after initiation of ART. The main objective of the study was to determine the time for virological suppression and its associated factors among people living with HIV taking antiretroviral treatments in East Shewa zone, Oromiya, Ethiopia. Methods: The study was conducted in East Shewa zone, Oromiya, Ethiopia from August 2017 to January 2018. Patients diagnosed with human immunodeficiency virus presenting to the study health centers between October 3, 2011 and March 1, 2013 were included in the study given the following criteria: age 18 years or greater, eligible to start ART. All patients with baseline viral load measurement were included in the study. Interaction between explanatory variables with the response variable was analyzed by using cross tab features of SPSS, IBM Inc. Significance group comparison was done by Kaplan Meier log rank test. Cox proportional hazard model was used to select significant factors to the variability between groups. Data was collected by using structured questionnaires and interview. A total of ETB 81,120.00 was utilized to carry out the study. Result: plasma viral load was suppressed below detection level in 72% of individuals taking different regimen of ART. The median HIV-1 plasma viral load in the cohort was log 5.3111 copies/ml. Survival curve difference were observed in category of marital status (p-value 0.023) and baseline CD4 values (p-value 0.023) whereas no significant difference were observed in Educational status (p-value 0.404), MUAC (p- value 0.407) BMI(p-value 0.335) and BTB(pvalue 0.257). Estimated median time to PVL suppression was 181days (CI: 140.5-221.4) with the age group of 30-39years having minimum time to achieve suppression with 92 days (CI:60.1-123.8) and the maximum time required to reach the level was age group between 50-59 years. Conclusion: Estimated time to achieve Plasma Viral Load after taking ART was found to be 181 days. Factors affecting time to suppression level was marital status and baseline CD4. Funding: This research project is undertaken in partial fulfillment of the requirements for the degree of master's of public health in field epidemiology. All funding for the purpose of the project is covered St. Paul's hospital Millennium Medical College Department of Public Health. Declaration of Interests: The authors certify that we have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers' bureaus, membership, employment, consultancies, stock ownership or other equity interest, and expert testimony or patent-licensing arrangements), or non-financial intereest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. Ethics Approval: Ethical approval was obtained from Saint Paul’s Hospital Millennium Medical college public health department ethical review committee. Then the approval letter was forwarded to Oromiya regional health beauro. Finally, the approval letter from regional health bureau submitted to Adama regional laboratory where the actual study was done. Study participants provided written informed consent. Informed consent were received from illiterate study participants in the previous study (35).