Virologic re-suppression and the associated factors among children aged 1-9 years on Antiretroviral Therapy in The Aids Support Organization Soroti Region, Uganda: a retrospective cohort analysis

Abstract

Background: Children living with HIV experience low viral load re-suppression after a high viral load compared to the rest of the population. We determined the proportion with re-suppressed viral load and associated factors among children 1-9 years on Antiretroviral Therapy (ART) in The Aids Support Organization (TASO) Soroti Region. Methods: We conducted a retrospective cohort analysis of 401 records of children that initially had high viral load > 1000copies/ml for the period January 2016 to December 2018. Modified Poisson regression was performed to determine factors associated with virologic re-suppression. Results: The prevalence of virologic re-suppression was 97/401 (24.2%). More than half, 213 (53.1%) of the children were females and 197/401 (49%) were aged between 8 and 9 years. Factors associated with virologic re-suppression were; being on protease inhibitor (PI) based regimen [APR 2.87, 95% CI 1.76-4.79], good adherence [APR1.71, 95% CI 1.22-2.51] and caregiver HIV seropositive status [APR 2.56, 95% CI 1.69-3.91]. Conclusion: Virologic re-suppression was low compared to the UNAIDS target. Taking PI-based regimen, good adherence and HIV seropositive status of the caregiver were predictors of virologic re-suppression. Close viral load monitoring of children on ART and intensified targeted adherence support to caregivers is vital to improving virologic re-suppression. Keywords: Virologic re-suppression; Human Immunodeficiency Virus; children.