Incidence and predictors of Viral load suppression after initiation of dolutegravir among HIV patients on ART in west Gondar zone, Ethiopia, 2022

Abstract

Introduction: The global estimate of viral load suppression was different in different age group and duration of antiretroviral therapy initiation. The proportion of adults with viral suppression was 44%, 36%, 29% after one, two and three years of antiretroviral therapy initiation. As 90-9090 target in 2020, the third 90 was 90% of patients on antiretroviral therapy would attain virally

suppressed, as a result USAID reported that 90% of antiretroviral therapy initiation patients were

virally

suppressed. In Ethiopia after the initiation of 90-90-90 strategy about 87% of patients have suppressed viral load. Objective: To assess the incidence and predictors of viral load suppression after the initiation of dolutegravir among HIV Patients on ART in West Gondar zone, North West Ethiopia, 2022 Methods: institutional based retrospective Follow up study was conduct in west Gondar zone from July 10 to July 24, 2022. Five public health facilities were selected by lottery method and proportional sample size allocation was applied for each facility. Data abstraction checklist was prepared to extract data. Systematic sampling technique was used to reach the sampled chart. The data were entered, cleaned and coded by using Epi-data and analyzed by STATA version 14. Kaplan-Meier survival curve, Bi-variable and multivariable Cox proportional hazard model was used to identify predictors of viral load suppression. Result: The overall incidence rate of viral load suppression among Dolutegravir initiated patients were 6.93 per 100 person-months (with 95% CI: 6.33-7.59). The median time of viral load suppression was 12 months. A patient with employer AHR 1.73 (95% CI= 1.03-2.92), overweight, AHR=2.93(95% CI=1.35-6.37) and duration antiretroviral therapy less than 12 months AHR: 3.69 (95%, CI: 1.69-9.03) and baseline regimen type TDF-3TC-EFZ AHR=1.9(95%, CI=1.00-3.59) were significant predictors of viral load suppression after the initiation of Dolutegravir among HIV Patients on antiretroviral therapy. Conclusion: In this study the incidence rate of viral load suppression after dolutegravir initiation was 6.93%. Employer, overweight, baseline regimen types 1e and duration of ART were significant predictors of viral load suppression after Dolutegravir initiation. It emphasizes the need for intensive nutritional counseling to improve viral load suppression is strongly recommended by this study