Virologic Response among Children and Adults in an Antiretroviral Therapy Programme in Northern Nigeria: A Cross-Sectional Descriptive Study

Introduction: Viral load suppression is a key determinant of successful anti-retroviral therapy. The study aimed to determine virologic response to Antiretroviral therapy in the large cohort of children and adults living with Human Immune deficiency Virus. Materials and Methods: Viral Load results from the HIV Ribonucleic Acid Polymerase Chain Reaction register of 10,887 children and adults on cART in 4 states in Northern Nigeria between 2017 and 2019 were retrieved and analyzed in the PCR Molecular Laboratory of the Federal Teaching Hospital, Gombe. Results: 10,887 children and adults were analyzed. Males were 28.4% (3094) and 71.6% (7793) females. 2.9% (311); 3.5% (386); 7.3% (797); 65.2% (7098); 14.5% (1583); 5.2% (562) and 1.3% (150) were aged 0 - 9 years, 11 - 18 years; 19 - 25 years, 26 - 45 years; 46 - 55 years; 56 - 65 years and <65 years respectively. This first viral load was primarily routine in 96.3% (10,479). ART combination was Zidovudine/Lamivudine/Nevirapine (AZT/3TC/NVP) in 53.8% (5855/10887), Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) in 44.7% (4864). Prior to viral load testing, 48.5% (5275/10887) had received HAART for 1 - 5 years; 7.4% (811/10887) for 6 months but <1 year; 37.4% (4075) 6 - 10 years and 6.7% (726) for >10 years. The most recent CD4count before viral load request was ≥1000/μL in 7.4% (810/10887); 500 -999/μL in 39.0% (4240); 350 - 499 μL in 22.7% (2466) and <350 μL in 30.9% (3371) in these patients. Viral load was ≥1000 c/mL in 24.8% (2697) of PLHIV tested. Viral load was >1000 c/mL in 26.5% (821/3094) males and 24.1% (1876/7793) females. Viral load was significantly lower among females (p-value 0.007). 50.5% (157/311); 52.1% (201/386); 28.5% (227/797); 23.5% (1670/7098); 19.9% (315/1583); 17.8% (100/562) and 18.0% (27/150) aged 0 - 9 years, 11 - 18 years; 19 - 25 years, 26 - 45 years; 46 - 55 years; 56 - 65 years and <65 years had viral load >1000 c/mL respectively. Viral load was >1000 c/mL in 28.2% (229/811) for those on HAART for 6 months - 1 year and 23.6% (1243/5275) after receiving Highly Active Antiretroviral Therapy (HAART) for 1 - 5 years. 26.3% (1072/4075) and 21.1% (153/726) had viral load > 1000 c/mL after receiving HAART for 6 - 10 and >10 years respectively (p-value 0.001). Conclusion: HIV viral suppression was below the WHO recommended threshold.