Abstract：
BACKGROUND: Enhanced adherence counseling refers to the counseling intervention for Human Immunodeficiency Virus (HIV) patients with an elevated viral load result, a viral load of > 1000 copies/ml, on a routine or need-based viral load test. The Federal Ministry of Health, Ethiopia, has launched routine viral load testing and enhanced adherence counseling since 2016 for high-viral load people living with HIV, which is applicable throughout the country for all health facilities providing HIV care and treatment. Our study aimed to assess viral load suppression after enhanced adherence counseling and its predictors among high viral load people living with HIV who were on antiretroviral therapy.
METHODS: We conducted a health facility-based retrospective follow-up study among 352 HIV-infected high-viral load people enrolled in enhanced adherence counseling from July 2018 to June 2021 in Nekemte town public health facilities. Cox proportional hazard analysis was used to identify independent predictors.
RESULTS: The overall 65.1% of 352 persons on antiretroviral treatment achieved HIV viral load suppression after enhanced adherence counseling, (15.01 per 100 person months (95% CI13.02-16.99)). The median time to viral load suppression was 5 months. Age ≥ 15 years (AHR = 1.99, 95% CI: 1.11-3.57), no history of opportunistic infection (AHR = 2.01, 95% CI: 1.18-3.41), and not using substances (AHR = 2.48, 95% CI: 1.19-5.14) were more likely to have viral load suppressed, while having an initial viral load count greater than 50,000 RNA copies/ml (AHR = 0.56, 95% CI: 0.37-0.85) were less likely to have viral load suppressed after enhanced adherence counseling.
CONCLUSIONS: Age, history of opportunistic infections, substance use, and an initial viral load count > 50,000 RNA copies/mL were significant predictors of viral load suppression. Enrolling all high-viral-load patients in enhanced adherence counseling is recommended for viral load suppression.
METHODS: We conducted a health facility-based retrospective follow-up study among 352 HIV-infected high-viral load people enrolled in enhanced adherence counseling from July 2018 to June 2021 in Nekemte town public health facilities. Cox proportional hazard analysis was used to identify independent predictors.
RESULTS: The overall 65.1% of 352 persons on antiretroviral treatment achieved HIV viral load suppression after enhanced adherence counseling, (15.01 per 100 person months (95% CI13.02-16.99)). The median time to viral load suppression was 5 months. Age ≥ 15 years (AHR = 1.99, 95% CI: 1.11-3.57), no history of opportunistic infection (AHR = 2.01, 95% CI: 1.18-3.41), and not using substances (AHR = 2.48, 95% CI: 1.19-5.14) were more likely to have viral load suppressed, while having an initial viral load count greater than 50,000 RNA copies/ml (AHR = 0.56, 95% CI: 0.37-0.85) were less likely to have viral load suppressed after enhanced adherence counseling.
CONCLUSIONS: Age, history of opportunistic infections, substance use, and an initial viral load count > 50,000 RNA copies/mL were significant predictors of viral load suppression. Enrolling all high-viral-load patients in enhanced adherence counseling is recommended for viral load suppression.
摘要：
背景：增强依从性咨询是指对病毒载量升高的人类免疫缺陷病毒（HIV）患者的咨询干预，病毒载量>1000拷贝/毫升，常规或基于需求的病毒载量测试。联邦卫生部,埃塞俄比亚,自2016年以来，已经为高病毒载量艾滋病毒感染者启动了常规病毒载量测试和加强依从性咨询，这适用于全国所有提供艾滋病毒护理和治疗的保健设施。我们的研究旨在评估在接受抗逆转录病毒治疗的高病毒载量HIV感染者中加强依从性咨询后的病毒载量抑制及其预测因素。
方法：我们对2018年7月至2021年6月在Nekemte镇公共卫生机构参加强化依从性咨询的352名HIV感染高病毒载量人群进行了一项基于医疗机构的回顾性随访研究。Cox比例风险分析用于确定独立预测因子。
结果：352名接受抗逆转录病毒治疗的人中，有65.1%的人在强化依从性咨询后实现了HIV病毒载量抑制。（每100人月15.01（95%CI13.02-16.99））。病毒载量抑制的中位时间为5个月。年龄≥15岁（AHR=1.99，95%CI：1.11-3.57），无机会感染史(AHR=2.01,95%CI:1.18-3.41),和不使用物质（AHR=2.48，95％CI：1.19-5.14）更有可能抑制病毒载量，尽管初始病毒载量计数大于50,000个RNA拷贝/ml(AHR=0.56,95%CI:0.37-0.85),但在加强依从性咨询后,病毒载量抑制的可能性较小.
结论：年龄，机会性感染史，物质使用,初始病毒载量计数>50,000RNA拷贝/mL是病毒载量抑制的重要预测因子。建议将所有高病毒载量患者纳入增强依从性咨询，以抑制病毒载量。
方法：我们对2018年7月至2021年6月在Nekemte镇公共卫生机构参加强化依从性咨询的352名HIV感染高病毒载量人群进行了一项基于医疗机构的回顾性随访研究。Cox比例风险分析用于确定独立预测因子。
结果：352名接受抗逆转录病毒治疗的人中，有65.1%的人在强化依从性咨询后实现了HIV病毒载量抑制。（每100人月15.01（95%CI13.02-16.99））。病毒载量抑制的中位时间为5个月。年龄≥15岁（AHR=1.99，95%CI：1.11-3.57），无机会感染史(AHR=2.01,95%CI:1.18-3.41),和不使用物质（AHR=2.48，95％CI：1.19-5.14）更有可能抑制病毒载量，尽管初始病毒载量计数大于50,000个RNA拷贝/ml(AHR=0.56,95%CI:0.37-0.85),但在加强依从性咨询后,病毒载量抑制的可能性较小.
结论：年龄，机会性感染史，物质使用,初始病毒载量计数>50,000RNA拷贝/mL是病毒载量抑制的重要预测因子。建议将所有高病毒载量患者纳入增强依从性咨询，以抑制病毒载量。
