Assessment of Treatment Outcomes of HIV Patients at the Omdurman management AIDS counseling Unit (OMACU) through using the Viral Load from March 2020 –August 2022

Abstract

<title>Abstract</title> Background HIV is a major public health problem, and its treatment involves antiretroviral therapy (ART), endeavoring to suppress the viral load to an undetectable level. It is important to identify and manage determinants of treatment failure among HIV-infected individuals to achieve optimal viral suppression. In Sudan, the data on first-line ART failure and determinants remains limited and insufficient. Aim To assess the treatment outcome of HIV patients using the viral load. Methods A cross-sectional hospital-based study enrolled 270 HIV patients in the Omdurman Management AIDS Care Unit (OMACU) during the period from March 2020 to August 2022. Data on demographics, clinical characteristics, and laboratory investigations were collected. Viral loads and WHO clinical stages at ART initiation and after one- year were included. Viral failures were defined as viral loads above 1,000 copies/mL. Results Out of 270 patients, 157 (58%) were males and 113 (42%) were females. Most of them, 188 (69.7%), were aged 25–49 years. Most of the cases 165 (61.1%) started the HAART in 2015 and above. Most of the cases, 157 (58.1%), had WHO stage III initially. There are no significant changes in WHO classification after one year of drug use (P = 0.682). The rates of undetected or below 50 copies/mL viral load increased after one- year of drug use from 50.7–71.9% (P = 0.039). The overall viral failure rate was 15% (n = 41). The WHO-class-IV (OR = 12.5; CI = 2.3–67.1; P = 0.003) and poor medication adherence (OR = 23.1; CI = 3.9-136.1; P = 0.001) were the independent risk factors of viral failure. Conclusion The virological failure of first-line ART was as high as 15%. The study demonstrated that virological failure was associated with factors amenable to recognition through regular screening and early interventions. Advanced WHO clinical stages and poor ART drug adherence were significant determinants of virological failure.