Virological failure among HIV infected individuals on antiretroviral therapy in Pune, India: a cross-sectional study

Abstract

Background: It is important to identify and manage determinants of virological failure among HIV infected individuals on treatment for achieving viral suppression. This study aimed to identify proportion and factors associated with virological failure among HIV infected individuals receiving first line antiretroviral therapy (ART).Methods: A total of 2670 adult HIV infected individuals attending ART centre at ICMR-National AIDS Research Institute, between January 2005 and June 2019 and having their recent viral load done after implementation of guidelines on routine viral load testing were included. Data were reviewed and analysed.Results: Of the 2670 people living with HIV (PLHIV) on first line antiretroviral therapy, 48% were male and 69% were more than 40 years of age. Mean baseline CD4 count at ART initiation was 252 cells/mm3 (SD:210, IQR 116-313) Overall, 13% (340/2670) of the participants showed virological failure. In multivariate analyses, participants with younger age and males retained significant association. Those with baseline CD4 counts of less than or equal to 500 cells/mm3 at treatment initiation (adjusted OR 1.71; 95% CI 1.08-2.70; p=0.022) and ART adherence ≤95% within last three months of recent viral load determination (adjusted OR 1.55, 95% CI of AOR 1.04-2.32; p=0.031) had higher risk for virological failure as compared to others. PLHIV with ART substitution due to various reasons were almost twice as likely to have virological failure (adjusted OR 1.83, 95% CI 1.44-2.33; p<0.001).Conclusions: It is crucial to focus on factors leading to virological failure among HIV infected individuals attending ART centre. Early linkage to treatment and ART initiation along with adherence counselling at every follow up visit play an important role in mitigating virological failure.

Antiretroviral treatment failure and associated factors among people living with HIV on therapy in Homa Bay, Kenya: A retrospective study

“…Although the rate of VTF was higher among PLHIV who stated ART with CD4 <200 cells/mL (11.6% (95% CI: 8.1%, 15.1%)) compared to those who started ART with CD4 > = 200 cells/ mL (8.1% (95% CI:6.4%, 9.9%)), this difference was not statistically significant, p = 0.062. The failure rate of 3.7% among adults in this study was inconsistent with previous findings from studies conducted among adults in Ethiopia, Uganda, India, and Kenya [13,14,[22][23][24][25][26][27], where rates of VTF among adults ranged from about 10% to as high as 34%. Many of these studies however, used the definition of two consecutive VL >1000 copies/ml 3 3 months apart, without the condition of adherence counseling, somewhat different to the definition used in our study.…”

Investigation of metabolic syndrome among people living with HIV: insight from a comparative study

“…Nonetheless, Amaewhule et al (2021) reported a higher prevalence (41.1%) of MetS among apparently healthy individuals. This relatively high prevalence may be due to an increase in the adoption of Western (Ayodele et al, 2012;Bosho et al, 2018;Kiama et al, 2018, Shidhaye et al, 2023Muhammad et al, 2017). The variation in the prevalence of MetS among PLWHIV may be due to various criteria used, sample size and also the methodology of the study.…”