HIV viral suppression outcomes of Tenofovir- and Abacavir-based antiretroviral regimens among children on ART in Zambia

Abstract

Introduction: Use of ART has remarkably decreased HIV related morbidity and mortality rates globally. Children living with HIV in Zambia are initiated on an Abacavir-based regimen to suppress viral replication. This study assessed the achievement of HIV viral suppression among children taking Abacavir and Tenofovir-based regimens and the predicting factors associated with viral load suppression in Zambian children. Methods: This was a retrospective cross-sectional analysis of routinely collected data on all children diagnosed with HIV aged below 15 years attending the ART clinic from 1 January 2016 to 31 December 2018 at the Paediatric University Teaching Hospital in Lusaka, Zambia. Logistic regression was used to explore factors associated with HIV virological suppression. Ethical approval for the study was sought from the University of Zambia Biomedical Research Ethical Committee and the National Health Research Authority. Results: About 78.4% of children on ART achieved virological suppression (262/334). An increase in age showed about 20% reduced odds of virological suppression (AOR 0.80, CI 0.71-0.95), while a child on ABC/3TC/LPV-r combination of ART compared to TDF/XTC/DTG, showed about 88% reduced odds of virological suppression (AOR 0.12, CI 0.04-0.41). Conclusion: Despite an increased uptake of ART, the viral suppression found in this study was lower than the UNAIDS target of 95% of people on ART to be virally suppressed. Greater sensitization and education on the importance of treatment adherence are required to achieve this target, and further studies are needed to determine the factors contributing to the low viral load suppression in children.