Reaching HIV epidemic control in Nigeria using a lower HIV viral load suppression cut-off

Abstract

Background: Virologic suppression (VS) has been defined using an HIV viral load (VL) of <1,000 copies/mL. Low-level viremia (51-999 copies/mL) is associated with an increased risk of virologic failure and HIV drug resistance. Methods: Retrospective data from persons with HIV (PWH) who initiated ART between January 2016–September 2022 in Nigeria were analyzed for VS at cut-off values <1000 copies/mL. Results: In 2022, VS at <1000 copies/mL was 95.7%. Using cut-off values of <400, <200 and <50 copies/mL, VS was 94.2%, 92.5%, and 87.0%, respectively. Discussion: Monitoring VS using lower cut-off values, alongside differentiated management of low-level viremia, may help Nigeria achieve HIV epidemic control targets.