Risk factors for delayed viral suppression on first-line antiretroviral therapy among persons living with HIV in Haiti, 2013-2017.
Adolescent
Adult
Anti-HIV Agents
/ adverse effects
Antiretroviral Therapy, Highly Active
/ adverse effects
Child
Child, Preschool
Female
HIV Infections
/ drug therapy
HIV-1
/ drug effects
Haiti
/ epidemiology
Humans
Lamivudine
/ therapeutic use
Male
Middle Aged
Nevirapine
/ adverse effects
Risk Factors
Viral Load
/ drug effects
Young Adult
Zidovudine
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
19
07
2019
accepted:
02
10
2020
entrez:
29
10
2020
pubmed:
30
10
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Studies of viral suppression on first-line antiretroviral therapy (ART) in persons living with human immunodeficiency virus (PLHIV) in Haiti are limited, particularly among PLHIV outside of the Ouest department, where the capital Port-au-Prince is located. This study described the prevalence and risk factors for delayed viral suppression among PLHIV in all geographic departments of Haiti between 2013 and 2017. Individuals who received viral load testing 3 to 12 months after ART initiation were included. Data on demographics and clinical care were obtained from the Haitian Active Longitudinal Tracking of HIV database. Multivariable logistic regression was performed to predict delayed viral suppression, defined as a viral load ≥1000 HIV-1 RNA copies/mL after at least 3 months on ART. Viral load test results were available for 3,368 PLHIV newly-initiated on ART. Prevalence of delayed viral suppression was 40%, which is slightly higher than previous estimates in Haiti. In the multivariable analysis, delayed viral suppression was significantly associated with younger age, receiving of care in the Ouest department, treatment with lamivudine (3TC), zidovudine (AZT), and nevirapine (NVP) combined ART regimen, and CD4 counts below 200 cells/mm3. In conclusion, this study was the first to describe and compare differences in delayed viral suppression among PLHIV by geographic department in Haiti. We identified populations to whom public health interventions, such as more frequent viral load testing, drug resistance testing, and ART adherence counseling should be targeted.
Identifiants
pubmed: 33119631
doi: 10.1371/journal.pone.0240817
pii: PONE-D-19-20432
pmc: PMC7595392
doi:
Substances chimiques
Anti-HIV Agents
0
Lamivudine
2T8Q726O95
Zidovudine
4B9XT59T7S
Nevirapine
99DK7FVK1H
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0240817Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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