Revista de SIDA e investigación clínica

Treatment Outcomes and Risk Factors Associated With Low Level Viremia among Adults on First Line Antiretroviral Therapy - A Case of Harare Central Hospital, Zimbabwe

Abstract

Katsidzira A and Gonah L

Background: The study sought to determine the treatment outcomes of patients on first line ART with low level viremia (51-1000 copies/mL) as well as the risk factors for subsequent treatment failure at Harare Central Hospital in Zimbabwe.

Method: A cohort of 300 medical records of patients who were on first line ART between 01 January 2013 and 31 December 2016, and who had low level viremia at least 6 months post ART initiation were followed up to determine the treatment outcome.

Results: While only a single individual died, 11% had persistent low-level viremia, 74% suppressed, 8% failed treatment, and 6% had been transferred out and thus their treatment outcome could not be established. Only 17% recorded new opportunistic infection. The hazard of treatment failure were 3.37 times higher in subjects with 0-200 CD4 when compared to those with CD4 > 350 at baseline, while there were no significant differences in the hazard of treatment failure between subjects with 201 to 350 and >350 CD4 count at baseline. The hazard of treatment failure were 2.06 times higher in subjects taking ABC-N when compared to those on TENOLAME while there were no significant differences in the hazard of treatment failure between subjects on TENOLAME and TENOLAMN. There was no association between hazard of failing treatment and WHO stage, marital status, employment and duration on ART.

Conclusion: Patients with low level viremia must be closely monitored for timely switch to second line ART in the event of treatment failure.