Abstract

Background: Adherence to Antiretroviral therapy has been strongly correlated with HIV viral suppression, reduced rates of resistance, increased survival, and improved quality of life. The objective of this study was to evaluate antiretroviral treatment monitoring and determine the factors affecting response to treatment of HIV patients in Massawa hospital, Eritrea.
Methods: It was a cross sectional type with medical records review among HIV patients in Massawa antiretroviral therapy clinic. A checklist was used as data collection tool from patients and medical cards, from April 16 to June 23, 2019. Data was entered in CSPro 7.2 and analyzed by SPSS version 21. Results were presented in tables, chi-squared test and odds ratio. Ethical approval was obtained from Ministry of health research and ethical clearance committee of Eritrea, and written Consent was obtained from the patients.
Results: A total of 180 patients were enrolled in the study, dominated by females (74.4%) and Tigrigna ethnic group (71.7%). During starting antiretroviral treatment, 62.8% patients had CD4 level <200 cells/μl and were on clinical stages II (32.2%) and III (46.7%). The current CD4 and viral load level of most patients were above 500 cells/μl (52.8%) and undetectable (<40 copies/ml) in 75% of cases respectively. Furthermore; 98.3% of the patients were currently in clinical stage I. Patients with fair adherence had lower CD4 count (AOR=0.03, 95% CI=0.0-0.19) and viral load suppression (AOR=0.02, 95%CI=0.0-0.2). Nonsmokers were about two times and 37 times more likely to have a higher CD4 level and undetectable viral load <40 copies/ml when compared to smokers respectively.
Conclusion: Most patients’ current viral load was undetectable with increased CD4 count and improved clinical stage. Male gender and poor adherence was the main factors significantly associated with poor response to Antiretroviral Therapy. Further prospective studies with larger sample size are required.

Keywords: HIV; Antiretroviral therapy; viral load; Adherence; Virulogical failure; Immunological failure