| dc.description.abstract | The goal of antiretroviral therapy is to maximize the inhibition of infectious virion production to below the level of detection of less than 50 copies/ml. Clients with LLV have not been fully studied in Uganda and inconsistent conclusion elsewhere have been opined pertaining their management. This study aimed to identify the factors associated with low level viremia and subsequent virological non suppression among adult HIV clients in the Kampala Central division between January 2015 and December 2019. It was a retrospective cohort study of adult HIV clients with low level viremia at St. Balikudembe and St. Charles Furthing clinics in Kampala Central division between January 2015 and December 2019. Participants were aged ≥18 years on antiretroviral therapy for at least one year. Secondary and primary data were used. Low level viremia (LLV) was categorized into low, medium, and high LLV. The presence of virological non suppression as a binary variable was the outcome. Virological non suppression was defined as viral load ≥1000 copies/ml. Modified Poisson regression with incidence rate ratio as the measure of association was used to assess the factors associated with virological non suppression. All analyses were done using STATA college station TX version 14 with a level of significance set at 5%. Of 316 participants, 182 (57.6%) were females, 228 (72.1%) were aged <45 years, and median age of participants was 39 years (Inter quartile range (IQR) 33-47). Forty seven out of 316 (14.9%) participants experienced virological non suppression. After adjusting for other variables; having medium LLV (adjusted incidence rate ratio (aIRR), 2.59 [95%CI, 1.16-5.76]), high LLV (aIRR, 4.56 [95%CI, 2.23-9.30]), fair adherence score (aIRR, 2.73 [95%CI, 1.53-4.86]) and poor adherence score (aIRR, 3.66 [95%CI, 1.59-8.40]) and being on PI based regimen (aIRR, 1.91 [95%CI, 1.05-3.47]) were significantly associated with virological non suppression. Age over 35 years was protective against virological non-suppression. Virological non-suppression is common among HIV clients with LLV on ART. Medium and high LLV, protease inhibitor-based regimen, age category, fair and poor adherence to ART were associated with virological non-suppression among clients with LLV. Health workers should offer closer monitoring, review and adherence support especially to low-level viremia young clients on protease inhibitors, with medium and poor adherence. More research is needed in the assessment of the drug resistance profile of the clients with LLV. | en_US |
