Clinical predictors and correlates of viral suppression among adults accessing care at the HIV clinic in federal medical center, Abeokuta, Ogun state, Nigeria: a retrospective cohort study

Abstract

Background: Globally, Human Immune-deficiency Virus (HIV) continues to be one of the world's most significant public health issues. At the end of 2022, 39.0 million people were living with HIV (PLHIV) worldwide with 9% resident in Nigeria. Viral suppression is associated with a reduction in HIV disease progression. However, Nigeria is yet to achieve the UNAIDS 2020 third 95, community wide viral suppression for elimination of global HIV epidemic. This study assessed the clinical predictors and correlates of viral suppression among adults accessing care at HIV clinic in Federal Medical Center, Abeokuta, Ogun State, Nigeria.

Methods: The study design was a facility-based retrospective cohort study that was conducted among adults on antiretroviral therapy (ART) at HIV clinic from May 2016 to October 22, 2021, Federal Medical Center of Abeokuta (FMCA), Ogun State Nigeria. Two thousand one hundred and seventy-six (2176) case records were explored within the study period, but only one thousand five hundred and twenty (1520) met the inclusion criteria. Variables in the participants' hospital record (secondary data) were extracted into Microsoft Excel which were exported into Stata MP 17 for data cleaning and recoding, and analysis. Stepwise model selection was done for factors associated with viral suppression and binary logistic regression was used to investigate the predictors of viral suppression among participants at p-value < 0.05.

Results: One thousand five hundred and twenty (1520) were included in the study. Majority (1116 - 73.4%) of the study participants were females and 241(15.9%) were aged 25-34 years. One thousand three hundred and eighty-six (1386- 90%) of the clients achieved viral suppression. Predictors of viral suppression were older age group of 25-34 years (OR: 2.62, 95% CI: 1.19-5.78, p < 0.017) and > 45 years (OR: 2.42, 95% CI: 1.11-5.28, p < 0.026), and active on ART (OR: 6.05, 95% CI: 4.10-8.91, p < 0.000).

Conclusion: This study showed a significant viral suppression among the study participants. Being active on ART and age 25 years and above were the only significant clinical predictor and correlate of viral suppression respectively. Improving viral suppression should be a focus among adults HIV under age 25 years and loss to follow-up (LTFU) category.

Keywords: Clinical predictors; HIV; Retrospective study; Viral suppression.