A retrospective study on HIV virological recovery patterns and factors associated with HIV viral treatment using highly active antiretroviral therapy (HAART) in public health facilities in tigray, Northern Ethiopia.

Background: Viral load monitoring is crucial for identifying treatment failure in HIV/AIDS patients, as low viremia is essential for public health as HIV cannot spread undetectable. This study aimed to assess the sustained virological recovery rate and potential factors affecting HIV patients in Tigray, Northern Ethiopia, receiving combination treatment.

Methods: HIV infected individuals receiving highly active antiretroviral therapy (HAART) were the subjects of the retrospective, cross-sectional investigation held from July 2018 to December 2020. Using a standardized checklist, data was taken from the Tigray Health Bureau database and aligned with data from the Tigray Health Research Institute (THRI). SPSS version 25.0 was used to analyze the data. Predictors for persistent virological recovery were identified based on baseline viral load, baseline CD4 count, current and baseline age, loss to follow-ups, adherence, and WHO clinical presentations. The correlations between each factor and the categorical outcome variables were evaluated using Pearson's χ2. To determine the determinants impacting virological recovery, multivariate logistic regression analyses were performed. Significant relationship levels were established at p < 0.05.

Results: 7689 HIV infected individuals with a mean age of 43 ± 13 years were recruited on HAART with a female predominance of 64.4% with 95% CI: 58.3-76.3. At enrollment to ART sizable portion of the research participants 43.7%, and 38% were in the productive age ranges of 16-30 and 31-45 years old respectively. The overall virological recovery was 90.9% with significant variations among male and female participants AOR; 4.24; 95% CI, 2.97-6.03) and (P < 0.001).

Conclusion: Male participants showed less recovery, with high baseline CD4 count, long therapy stays, and suppressed viral load being key predictors. The virological recovery (90.9%) remains below the global average which is 95%. Regular assessment of treatment response patterns and drug list combinations is crucial for HIV virological recovery to be sustained. Early enrollment in HAART, tailored interventions, baseline viral load monitoring, longitudinal studies, and gene sequencing are crucial for virological recovery and identifying genetic and behavioral factors contributing to treatment resistance.