Key Clinical Predictors of Viral Suppression in HIV Patients: A Study from Abeokuta, Nigeria
Study Setting and Design
Table of Contents
A retrospective cohort study was conducted at the Federal Medical Center of Abeokuta (FMCA) in Ogun State, Nigeria, from May 2016 to October 22, 2021. The clinic, established in 2006, provides specialized care for HIV patients and is supported by the AIDS Prevention Initiative in Nigeria (APIN). The FMCA is a regional specialist hospital with a capacity of 500 beds. In 2023, the HIV prevalence in Ogun State was 1.6%.
FMCA is a busy center for HIV care, offering comprehensive services. These services include initial consultations, ongoing counseling, disease stage assessment, antiretroviral therapy (ART), side effect management, and adherence checks.
Study Population and Sample Size
The study included HIV-positive participants aged 18 and above who received ART at FMCA. Out of 2,176 case records available from May 2016 to October 2021, only 1,520 were eligible for analysis due to incomplete data. The selected records contained participants’ socio-demographic information, medical history, and pharmacy records.
Study Variables
The main outcome measured was HIV viral suppression, determined via a single viral load measurement using reverse transcriptase-polymerase chain reaction (RT-qPCR). Viral suppression was defined as an HIV RNA measurement below a specified threshold.
Explanatory variables included socio-demographic and clinical characteristics such as age, sex, marital status, ART regimen, ART status, WHO clinical stage, and any clinical symptoms like cough or fever.
WHO Clinical Staging for HIV Disease
- Stage 1: Asymptomatic and persistent generalized lymphadenopathy.
- Stage 2: Moderate unexplained weight loss.
- Stage 3: Severe weight loss, chronic diarrhea, chronic fever, and severe bacterial infections.
- Stage 4: HIV wasting syndrome or opportunistic infections like Pneumocystis pneumonia.
Data Analysis
Data were extracted from hospital records into Microsoft Excel and then imported into Stata MP 17 for cleaning. Viral suppression was coded as 1, and non-suppression as 0. Categorical variables were summarized using frequencies and percentages, while continuous variables were described with mean and standard deviation. The relationship between outcome and factors was tested using Chi-square and Fisher’s exact tests. Significant factors were analyzed using binary logistic regression to identify predictors of viral suppression.