Evaluation of the HIV Viral Load laboratory based Surveillance System and characterisation of Viral Suppression in a rural County - Kenya, 2015–2018

  • Viral hepatitis and HIV
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Background:
Key among UNAIDS global targets to accelerate efforts towards control of HIV pandemic is viral suppression of 90% among patients on antiretroviral therapy. Viral suppression is important in disrupting HIV transmission. We evaluated the viral load surveillance system and characterized suppression of HIV as reported in the system.
Methods:
We evaluated the surveillance system attributes such as data quality, acceptability using CDC guidelines and re- viewed records in the national viral load database of HIV patients tested for viral load in Homabay County in Kenya from 2015–2018. Variables collected included age, gender and antiretroviral regimen. We abstracted data using standardized tool and descriptive statistics calculated. We categorized Patients with less than 1000 copies of HIV per ml as virally suppressed
Results:
We reviewed 224,822 records. Overall 1.6% of records had missing information on sex and 0.4% on age. The Labo- ratory sample rejection rate was 0.35%. High acceptability demonstrated by facilities reporting rate of 93.9%. Mean age was 35.8 years (SD ±14.6). Overall, viral suppression rate changed from 83% in 2015 to 89% in 2018. Female sup- pression rates (86.3%) were higher than male (83.5%). Paediatric (66.5%) and adolescent (67%) suppression rates were lower than for adult (87.8%). Suppression rate in the age group 1–10 years was 64.4% while for 50–60 years was 91.2%. Most common antiretroviral regimen was TDF/3TC/EFV (58.8%) with suppression rate of 91.6% while for ABC/3TC/LPVr was 74.1%. The system lacks a feedback mechanism from the clinics on patients receiving Results:.
Conclusion
The system had high data quality level and acceptability. Female viral suppression rates were higher than male while paediatric and adolescent suppression rates were lower as compared to adult rates. Patients on TDF/3TC/EFV regimen had the highest suppression rates of 91.6%. We recommended use of viral load surveillance data in mon- itoring treatment success particularly of paediatric and adolescent patients. We recommend variable on patients receiving result be added.

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