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Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study

BACKGROUND: Enhanced adherence counseling (EAC) is an interventional program that provides targeted adherence counseling for unsuppressed viral load people living with HIV who are receiving antiretroviral therapy before diagnosing treatment failure. However, there is a lack of evidence on change in...

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Autores principales: Diress, Gedefaw, Linger, Melese
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733336/
https://www.ncbi.nlm.nih.gov/pubmed/33324112
http://dx.doi.org/10.2147/HIV.S283917
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author Diress, Gedefaw
Linger, Melese
author_facet Diress, Gedefaw
Linger, Melese
author_sort Diress, Gedefaw
collection PubMed
description BACKGROUND: Enhanced adherence counseling (EAC) is an interventional program that provides targeted adherence counseling for unsuppressed viral load people living with HIV who are receiving antiretroviral therapy before diagnosing treatment failure. However, there is a lack of evidence on change in viral load count among patients receiving EAC intervention. Therefore, this study aimed to assess change in viral load count and its predictors among people living with HIV (PLHIV) in northeast Ethiopia. METHODS: A hospital-based retrospective follow-up study was conducted on 235 randomly selected patients with unsuppressed viral load who started EAC sessions between 2016 and 2019 at three governmental hospitals in the northern part of Ethiopia. Viral load count and patient individual factors were assessed at EAC program enrollment and viral load counts repeated at the end of EAC session. The main outcome variable was a change in viral load count during the EAC session period. A paired sample t-test was used to determine the mean difference in viral load count before and after EAC intervention. Linear mixed-effects models were used to assess the effect of selected factors on viral load count change. RESULTS: Based on the paired sample t-test, there was a significant mean difference in viral load count before and after EAC intervention (mean difference=16,904, (95% CI: 9986–23,821; p-value<0.001). The multivariable linear mixed-effects regression analysis showed that young age (β= 0.03; 95% CI: 0.01, 0.14), urban residence (β= −0.55; 95% CI: −0.63, −0.34), CD4 count of 201–500 cells/mm(3) (β= −0.67; 95% CI: −0.87, −0.43) and long duration on ART (β= −0.01; 95% CI: −0.01, −0.02) were associated with the decline in viral load count. CONCLUSION: We detected a substantial decline in viral load count among patients receiving an EAC intervention. Young age, urban residence, CD4 count of 201–500 cells/mm(3) and long duration on ART were the positive predictors of viral load suppression.
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spelling pubmed-77333362020-12-14 Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study Diress, Gedefaw Linger, Melese HIV AIDS (Auckl) Original Research BACKGROUND: Enhanced adherence counseling (EAC) is an interventional program that provides targeted adherence counseling for unsuppressed viral load people living with HIV who are receiving antiretroviral therapy before diagnosing treatment failure. However, there is a lack of evidence on change in viral load count among patients receiving EAC intervention. Therefore, this study aimed to assess change in viral load count and its predictors among people living with HIV (PLHIV) in northeast Ethiopia. METHODS: A hospital-based retrospective follow-up study was conducted on 235 randomly selected patients with unsuppressed viral load who started EAC sessions between 2016 and 2019 at three governmental hospitals in the northern part of Ethiopia. Viral load count and patient individual factors were assessed at EAC program enrollment and viral load counts repeated at the end of EAC session. The main outcome variable was a change in viral load count during the EAC session period. A paired sample t-test was used to determine the mean difference in viral load count before and after EAC intervention. Linear mixed-effects models were used to assess the effect of selected factors on viral load count change. RESULTS: Based on the paired sample t-test, there was a significant mean difference in viral load count before and after EAC intervention (mean difference=16,904, (95% CI: 9986–23,821; p-value<0.001). The multivariable linear mixed-effects regression analysis showed that young age (β= 0.03; 95% CI: 0.01, 0.14), urban residence (β= −0.55; 95% CI: −0.63, −0.34), CD4 count of 201–500 cells/mm(3) (β= −0.67; 95% CI: −0.87, −0.43) and long duration on ART (β= −0.01; 95% CI: −0.01, −0.02) were associated with the decline in viral load count. CONCLUSION: We detected a substantial decline in viral load count among patients receiving an EAC intervention. Young age, urban residence, CD4 count of 201–500 cells/mm(3) and long duration on ART were the positive predictors of viral load suppression. Dove 2020-12-07 /pmc/articles/PMC7733336/ /pubmed/33324112 http://dx.doi.org/10.2147/HIV.S283917 Text en © 2020 Diress and Linger. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Diress, Gedefaw
Linger, Melese
Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title_full Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title_fullStr Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title_full_unstemmed Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title_short Change in Viral Load Count and Its Predictors Among Unsuppressed Viral Load Patients Receiving an Enhanced Adherence Counseling Intervention at Three Hospitals in Northern Ethiopia: An Exploratory Retrospective Follow-Up Study
title_sort change in viral load count and its predictors among unsuppressed viral load patients receiving an enhanced adherence counseling intervention at three hospitals in northern ethiopia: an exploratory retrospective follow-up study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733336/
https://www.ncbi.nlm.nih.gov/pubmed/33324112
http://dx.doi.org/10.2147/HIV.S283917
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