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HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations

Routine viral load (VL) monitoring is the standard of care in Côte d’Ivoire and allows for effective treatment guidance for people living with human immunodeficiency virus (HIV) to reach viral load suppression (VLS). For VL monitoring to be effective in reducing the impact of HIV, it must be provide...

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Autores principales: Kemper, Kathryn E., Augusto, Orvalho, Gloyd, Stephen, Akoku, Derick A., Ouattara, Gbossouna, Perrone, Lucy A., Assoa, Paul Henri, Akoua-Koffi, Chantal, Adje-Toure, Christiane, Koné, Ahoua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501548/
https://www.ncbi.nlm.nih.gov/pubmed/37708102
http://dx.doi.org/10.1371/journal.pgph.0001822
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author Kemper, Kathryn E.
Augusto, Orvalho
Gloyd, Stephen
Akoku, Derick A.
Ouattara, Gbossouna
Perrone, Lucy A.
Assoa, Paul Henri
Akoua-Koffi, Chantal
Adje-Toure, Christiane
Koné, Ahoua
author_facet Kemper, Kathryn E.
Augusto, Orvalho
Gloyd, Stephen
Akoku, Derick A.
Ouattara, Gbossouna
Perrone, Lucy A.
Assoa, Paul Henri
Akoua-Koffi, Chantal
Adje-Toure, Christiane
Koné, Ahoua
author_sort Kemper, Kathryn E.
collection PubMed
description Routine viral load (VL) monitoring is the standard of care in Côte d’Ivoire and allows for effective treatment guidance for people living with human immunodeficiency virus (HIV) to reach viral load suppression (VLS). For VL monitoring to be effective in reducing the impact of HIV, it must be provided in accordance with national guidance. This study aimed to evaluate VL testing, VLS rates and adherence to national guidance for VL testing using data collected from three national laboratories. We collected data on VL testing between 2015–2018 from OpenELIS (OE), an open-source electronic laboratory information system. We merged data by unique patient ID for patients (0–80 years old) who received multiple VL tests to calculate time between tests. We defined VLS as HIV RNA ≤1,000 copies/mL based on Côte d’Ivoire national and WHO guidance at the time of data collection. We used the Kaplan-Meier survival estimator to estimate time between ART (antiretroviral therapy) initiation and the first VL test, time between subsequent VL tests, and to estimate the proportion of people living with HIV (PLHIV) who were virally suppressed within 12 months of ART initiation. At the first documented VL test, 79.6% of patients were virally suppressed (95% CI: 78.9–80.3). Children under 15 were the least likely to be virally suppressed (55.2%, 95% CI: 51.5–58.8). The median time from ART initiation to the first VL sample collection for testing was 7.8 months (IQR:6.2–13.4). 72.4% of patients were virally suppressed within one year of treatment initiation (95% CI:71.5–73.3). Approximately 30% of patients received a second VL test during the 4-year study period. The median time between the first and second VL tests was 24.9 months (IQR: 4.7->40). Most PLHIV received their first VL test within the recommended 12 months of ART initiation but did not receive subsequent VL monitoring tests within the recommended time frame, reducing the benefits of VL monitoring. While VLS was fairly high, children were least likely to be virally suppressed. Our findings highlight the importance of regular VL monitoring after the first VL test, especially for children.
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spelling pubmed-105015482023-09-15 HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations Kemper, Kathryn E. Augusto, Orvalho Gloyd, Stephen Akoku, Derick A. Ouattara, Gbossouna Perrone, Lucy A. Assoa, Paul Henri Akoua-Koffi, Chantal Adje-Toure, Christiane Koné, Ahoua PLOS Glob Public Health Research Article Routine viral load (VL) monitoring is the standard of care in Côte d’Ivoire and allows for effective treatment guidance for people living with human immunodeficiency virus (HIV) to reach viral load suppression (VLS). For VL monitoring to be effective in reducing the impact of HIV, it must be provided in accordance with national guidance. This study aimed to evaluate VL testing, VLS rates and adherence to national guidance for VL testing using data collected from three national laboratories. We collected data on VL testing between 2015–2018 from OpenELIS (OE), an open-source electronic laboratory information system. We merged data by unique patient ID for patients (0–80 years old) who received multiple VL tests to calculate time between tests. We defined VLS as HIV RNA ≤1,000 copies/mL based on Côte d’Ivoire national and WHO guidance at the time of data collection. We used the Kaplan-Meier survival estimator to estimate time between ART (antiretroviral therapy) initiation and the first VL test, time between subsequent VL tests, and to estimate the proportion of people living with HIV (PLHIV) who were virally suppressed within 12 months of ART initiation. At the first documented VL test, 79.6% of patients were virally suppressed (95% CI: 78.9–80.3). Children under 15 were the least likely to be virally suppressed (55.2%, 95% CI: 51.5–58.8). The median time from ART initiation to the first VL sample collection for testing was 7.8 months (IQR:6.2–13.4). 72.4% of patients were virally suppressed within one year of treatment initiation (95% CI:71.5–73.3). Approximately 30% of patients received a second VL test during the 4-year study period. The median time between the first and second VL tests was 24.9 months (IQR: 4.7->40). Most PLHIV received their first VL test within the recommended 12 months of ART initiation but did not receive subsequent VL monitoring tests within the recommended time frame, reducing the benefits of VL monitoring. While VLS was fairly high, children were least likely to be virally suppressed. Our findings highlight the importance of regular VL monitoring after the first VL test, especially for children. Public Library of Science 2023-09-14 /pmc/articles/PMC10501548/ /pubmed/37708102 http://dx.doi.org/10.1371/journal.pgph.0001822 Text en © 2023 Kemper et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kemper, Kathryn E.
Augusto, Orvalho
Gloyd, Stephen
Akoku, Derick A.
Ouattara, Gbossouna
Perrone, Lucy A.
Assoa, Paul Henri
Akoua-Koffi, Chantal
Adje-Toure, Christiane
Koné, Ahoua
HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title_full HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title_fullStr HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title_full_unstemmed HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title_short HIV viral load testing and monitoring in Côte d’Ivoire: A survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
title_sort hiv viral load testing and monitoring in côte d’ivoire: a survival analysis of viral load testing and suppression, and evaluation of adherence to national recommendations
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501548/
https://www.ncbi.nlm.nih.gov/pubmed/37708102
http://dx.doi.org/10.1371/journal.pgph.0001822
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