Factors associated with viral suppression and rebound in adult HIV patients on antiretroviral therapy

Abstract

Suppression of viral load and its maintenance are necessary for reducing morbidity and mortality linked to HIV infection. The present study aims to investigate the factors associated with viral load rebound in adults receiving antiretroviral treatment. The study was conducted in two outpatient treatment centers (CTAs) in Bangui. This cross-sectional analytical study was conducted from August 1 to 31, 2023. The study population comprised people living with HIV, followed by the two CTAs. This includes people living with HIV aged 18 and over, with at least two viral load results, the first of which is suppressed and who have agreed to participate in the study. The data were collected using an individual questionnaire designed and previously tested for clarity and length and through patient records. A total of 458 people living with HIV on antiretroviral treatment were enrolled in the study. The average age of our population was 42 years (±9). Among the 458 participants with a suppressed viral load, 78(17%) experienced a virological rebound. The main factors associated with the rebound in viral load were transport difficulties, poor compliance with treatment, and a poor perception of the concept of suppressed viral load. This study revealed that the poor perception of viral load and transport difficulties were associated with the rebound. Efforts must be made by the National AIDS Control Program to scale up the multi-month dispensation of antiretrovirals. Each clinic should put in place an adherence-improving self-management strategy system. Finally, the quality of the messages to be provided to patients must be improved to avoid confusion.