Observational studyInternational journal of STD & AIDS2018
Factors associated with recent unsuppressed viral load in HIV-1-infected patients in care on first-line antiretroviral therapy in South Africa.
Observational study in International journal of STD & AIDS, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis.Journal of the International AIDS Society · 2022Pooled it
- Exploring HIV disease indicators at MDR-TB treatment initiation in South Africa.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Trial
- Trial
- Trial
- Socio-economic condition and lack of virological suppression among adults and adolescents receiving antiretroviral therapy in Ethiopia.PloS one · 2020Trial
- Clinical and demographic characteristics of adult patients experiencing virologic failure on antiretroviral therapy in the Blouberg sub-district, South Africa.BMC infectious diseases · 2026Article
- Article
- Article
- Article
- HIV vertical transmission linked to virological failure in pregnant women on ART.AIDS research and therapy · 2025Article
- Article
- Factors affecting viral suppression or rebound in people living with HIV and receiving antiretroviral therapy in Ghana.Frontiers in public health · 2025Article
- Who gets missed in Zambia's antenatal HIV testing? Persistent inequities despite routine screening policies in Zambia.PLOS global public health · 2025Article
- Article
- Prevalence and factors associated with HIV viral rebound in individuals on ART: A systematic review study.Journal of public health in Africa · 2025Review
- Clinical Determinants Associated With Viral Load Count Among Adult TB/HIV Co-Infected Patients: A Linear Mixed-Effects Model Analysis.Advances in virology · 2025Article
- Predictors of HIV Viral Load Suppression After Enhanced Adherence Counseling, Nekemte, Ethiopia.Journal of epidemiology and global health · 2024Article
- Barriers to viral load suppression among adolescents living with HIV on anti-retroviral therapy: a retrospective study in Tanga, Tanzania.AIDS research and therapy · 2024Article
- Determinants of viral load suppression failure among HIV adults on ARV attending health care facilities: a retrospective study in Tanga region, Tanzania.BMC infectious diseases · 2024Article
- Factors associated with an unsuppressed viral load among HIV-positive individuals attending STI services in South Africa, 2019.BMC infectious diseases · 2024Article
4 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
Abstract
Unsuppressed viral load (VL) in patients on antiretroviral therapy (ART) occurs when treatment fails to suppress a person's VL and is associated with decreased survival and increased HIV transmission. The objective of this study was to evaluate factors associated with unsuppressed VL (VL > 400 copies/ml) in patients currently in care on first-line ART for ≥ 6 months attending South African public healthcare facilities. We analysed electronic medical records of ART patients with a VL result on record who started ART between January 2004 and April 2016 from 271 public health facilities. We present descriptive and multivariable logistic regression for unsuppressed VL at last visit using a priori variables. We included 244,370 patients (69% female) on first-line ART in April 2016 for ≥ 6 months. Median age at ART start was 33 years (7% were < 15 years old). Median duration on ART was 3.7 years. Adjusting for other variables, factors associated with having an unsuppressed VL at the most recent visit among patients in care included: (1) < 15 years old at ART start (adjusted odds ratio [aOR]=2.58; 95% CI = 2.37, 2.81) versus 15-49 years at ART start, (2) male gender (aOR = 1.29; 95% CI = 1.25, 1.35), (3) 6-12 months on ART versus longer (aOR = 1.34; 95% CI = 1.29, 1.40), (4) on tuberculosis (TB) treatment (aOR = 1.78; 95% CI = 1.48, 2.13), and (5) prior ART exposure versus none (aOR = 1.20; 95% CI = 1.08, 1.32). Approximately 85% of the ART cohort who were in care had achieved viral suppression, though men, youth/adolescents, patients with prior ART exposure, those with short duration of ART, and patients on TB treatment had increased odds of not achieving viral suppression. There is a need to develop and evaluate targeted interventions for ART patients in care who are at high risk of unsuppressed VL.
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