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Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators

View ORCID ProfileCharles Uzande, Jeffery Edwards, Philip Owiti, Admire Tatenda Maravanyika, Simba Mashizha, Patron Titsha Mafaune
doi: https://doi.org/10.1101/324350
Charles Uzande
1Provincial Medical Directorate (MOHCC) Manicaland Province Zimbabwe
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  • For correspondence: uzandecharles@gmail.com
Jeffery Edwards
2Médecins Sans Frontières, Operational Centre Brussels, Brussels Belgium
3Department of Global Health, University of Washington, Seattle, Washington, USA
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Philip Owiti
4International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
5National Tuberculosis, Leprosy and Lung Disease Programme, Nairobi, Kenya
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Admire Tatenda Maravanyika
4International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
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Simba Mashizha
1Provincial Medical Directorate (MOHCC) Manicaland Province Zimbabwe
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Patron Titsha Mafaune
1Provincial Medical Directorate (MOHCC) Manicaland Province Zimbabwe
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Abstract

Background: The third 90-90-90 UNAIDS goal require that 90% of people living with HIV (PLHIV) on antiretroviral treatment (ART) achieve viral load (VL) suppression. This study assessed the proportion of VL suppression and related factors among PLHIV on 1st and 2nd line ART in Mutare District, Manicaland Province, Zimbabwe between 2015-2017.

Methods: A retrospective study using routine HIV programme data from the electronic monitoring system for nine health facilities in Mutare District. VL suppression was defined as < 1,000 copies/ml.

Results: Of 16,590 registered patients, 15,566(94%) were on first-line and 1024(6%) on second-line ART. Of those on 1st-line ART, 2856(18%) had a VL test result documented, while 367(36%) of 2nd-line ART patients had VL results. VL suppression rates were 86% among those on 1st-line and 45% in 2nd-line ART. Independent risk factors associated with VL non-suppression for those on 1st-line ART were age 0-9 years (adjusted relative risk, aRR=2.9; 95% confidence interval, CI=1.7-4.8;P<0.001), 10-19 years (aRR=2.2;95%CI=1.4-3.2,P<0.001) compared to those 20-49 years, concurrent TB (aRR=9; CI=3.0-29.7,P<0.001) and male gender (aRR=1.5,95%CI=1.1-2.1;P=0.02). There were no significant risk factors associated with VL non-suppression for 2nd-line ART patients.

Conclusion: For PLHIV on 1st-line ART in Mutare district, Manicaland, Zimbabwe, the frequency of reported VL results were only 18% among those on 1st-line ART, while the rate of VL suppression was near 90%. Viral Load testing coverage appears to be lagging behind current Zimbabwe goals and increased support is needed to improve the quality of HIV care and help reduce the threat of possible HIV drug resistance in the future.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license.
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Posted May 16, 2018.
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Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators
Charles Uzande, Jeffery Edwards, Philip Owiti, Admire Tatenda Maravanyika, Simba Mashizha, Patron Titsha Mafaune
bioRxiv 324350; doi: https://doi.org/10.1101/324350
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Are you suppressed? Viral load test coverage for people living with HIV in Mutare District, Manicaland Province, Zimbabwe, 2015-2017 Investigators
Charles Uzande, Jeffery Edwards, Philip Owiti, Admire Tatenda Maravanyika, Simba Mashizha, Patron Titsha Mafaune
bioRxiv 324350; doi: https://doi.org/10.1101/324350

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