Gemechu Abdella, Mihret Adane, Atire Fekadu Alemu, Aseffa Abraham, Howe Rawleigh, Seyoum Berhanu, Mulu Andargachew
School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar P.O. Box 235, Ethiopia.
Armauer Hansen Research Institute, Addis Ababa P.O. Box 1005, Ethiopia.
Trop Med Infect Dis. 2023 Jul 30;8(8):391. doi: 10.3390/tropicalmed8080391.
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.
自从在埃塞俄比亚将基于度鲁特韦（DTG）的方案作为一线抗逆转录病毒治疗（ART）引入以来，将包括病毒载量（VL）检测在内的基线因素与病毒学抑制未达标的研究一直有限。本研究旨在确定2020年10月至2022年7月期间与病毒学抑制未达标相关的基线因素。在埃塞俄比亚东部对新诊断的艾滋病毒感染者（PLHIV）进行了一项随访研究。使用问卷和清单收集数据。在基线和六个月时采集5毫升静脉血以测定病毒载量。使用雅培实时HIV-1检测法进行病毒载量检测。为了确定病毒学抑制未达标的预测因素，采用了双变量和多变量逻辑回归分析。共纳入235名PLHIV，其中70.6%为女性，平均年龄33.9岁。在161名继续接受ART治疗的患者中，六个月时病毒学抑制未达标的比例为8.7%。病毒学抑制未达标的基线预测因素为年龄≤30岁、有药物使用史以及病毒载量大于4 log10拷贝/毫升。在该队列中，发现病毒学抑制未达标的情况处于最佳状态，但仍略落后于第三个95%目标。因此，建议采取有针对性的干预措施，引入基线病毒载量检测以改善治疗结果，并促进实现联合国艾滋病规划署的95-95-95目标。此外，建议开展更广泛的研究，以探索研究地区病毒学抑制未达标的原因。
