Virological Non-Suppression among Newly Diagnosed HIV-Positive Individuals on Dolutegravir-Based Antiretroviral Treatment in Eastern Ethiopia: Follow-Up Study

Abdella Gemechu; Adane Mihret; Fekadu Alemu Atire; Abraham Aseffa; Rawleigh Howe; Berhanu Seyoum; Andargachew Mulu

doi:10.3390/tropicalmed8080391

Virological Non-Suppression among Newly Diagnosed HIV-Positive Individuals on Dolutegravir-Based Antiretroviral Treatment in Eastern Ethiopia: Follow-Up Study

Trop Med Infect Dis. 2023 Jul 30;8(8):391. doi: 10.3390/tropicalmed8080391.

Authors

Abdella Gemechu^{1

2}, Adane Mihret², Fekadu Alemu Atire², Abraham Aseffa², Rawleigh Howe², Berhanu Seyoum², Andargachew Mulu²

Affiliations

¹ School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar P.O. Box 235, Ethiopia.
² Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia.

Abstract

There have been limited studies linking baseline factors, including the viral load (VL) test, with virological non-suppression since the introduction of dolutegravir (DTG)-based regimens as first-line antiretroviral treatment (ART) in Ethiopia. This study aimed to identify baseline factors associated with virological non-suppression between October 2020 and July 2022. A follow-up study was conducted in eastern Ethiopia among newly diagnosed people living with HIV (PLHIV). A questionnaire and a checklist were used to collect the data. Five milliliters of venous blood were obtained at baseline and six months to determine the VL. A VL test was performed using the Abbott RealTime HIV-1 assay. To determine predictors of virological non-suppression, bivariate and multivariate logistic regression analyses were used. There were 235 PLHIV enrolled, 70.6% of whom were female, with a mean age of 33.9 years. Of the 161 retained on ART, virological non-suppression was 8.7% at six months. Baseline predictors of virological non-suppression were age ≤ 30 years, a history of substance use, and a VL greater than 4-log10 copies/mL. In this cohort, virological non-suppression was found to be optimal but still lagged slightly behind the third 95%-target. Thus, targeted interventions, the introduction of baseline VL testing to improve treatment outcomes, and fostering the attainment of UNAIDS 95-95-95 targets are recommended. Furthermore, broader research is recommended to explore the reasons for virological non-suppression in the study area.

Keywords: HIV; baseline viral load; eastern Ethiopia; predictors; virological non-suppression.

Grants and funding

The Haramaya University postgraduate directorate and the Armauer Hansen Research Institute provided financial support for the research data collection. This research received no external funding.