Predictors of Virological failure among children infected with HIV-1 on Haart at KATH

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July, 2016
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HIV infection, which was a fatal disease, is now a chronic manageable disease as a result of intervention of anti-retroviral therapy. However a major challenge in resource limited centre settings is inadequate laboratory support for CD4 and HIV viral load monitoring of HIV infected patients receiving treatment. We determined the prevalence and risk factors associated with virological failure among children infected with HIV-1. Methods: One hundred and eighty-eight (188) children ≤17 years were recruited into a longitudinal study at Komfo Anokye teaching hospital from July 2015 to April 2016. Viral load testing, CD4 count and full blood count were done every four to six months. The data was analyzed using R statistical software and GraphPad prism. Results: HIV drug refill on time was used as a surrogate marker for adherence which revealed that 71.28% were treatment adherent. Twenty-one patients who were adherent to therapy had two consecutive viral loads above 1000 copies/ml. In this study the prevalence of virological failure was 15.67% among HIV infected children on treatment. Of the 21 patients who met the definition of virological failure, 19 (90.48%) patients failed first line drugs whereas 2 (9.52%) failed second line drugs. Logistic regression analysis revealed unemployed care providers and period of duration on HAART as predictors of virological failure.This study revealed 84.33% effectiveness of first line drugs among children infected with HIV-1 using WHO criteria for virologic failure. A prevalence of 15.67% virological failure was determined among children. This study identified unemployed care providers and period of duration on HAART as predictors of virological failure.
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A thesis submitted to the Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology in fulfillment of the requirement for the degree of Master of Science in Clinical Microbiology,
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