ArticleBMJ open2025
Prevalence and determinants of unsuppressed HIV viral loads among children and adolescents living with HIV on antiretroviral therapy in Lubumbashi, Democratic Republic of the Congo: a retrospective cross-sectional study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Unsuppressed viral load and its associated factors among people living with HIV on antiretroviral therapy: a cross-sectional study.BMC infectious diseases · 2026Article
- Predictive analysis of influencing factors on HIV testing behavior among college students in Shanxi, China.BMC public health · 2025Article
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Abstract
backgroundDespite global improvements in antiretroviral therapy (ART) access for children and adolescents living with HIV (CALHIV), a significant proportion continue to experience unsuppressed viral load (USVL). Limited studies focus on the factors contributing to USVL among CALHIV in the Democratic Republic of the Congo (DRC), especially in the context of evolving treatment landscapes. Understanding these determinants is crucial for enhancing ART outcomes.
objectiveThis study aimed to determine the prevalence of USVL and identify factors associated with USVL among CALHIV receiving ART in Lubumbashi, DRC.
designA multicentre retrospective cross-sectional study was conducted. Data were gathered using an observational checklist based on assessing patient file data and entered into Microsoft Excel. Analysis was performed using STATA V.16. Variables with a p value of 0.20 from the bivariable analysis were included in a multivariable logistic regression model, and significant variables (p<0.05) were retained in the final model. SETTING AND
participantsThe study was conducted at 21 HIV care clinics in Lubumbashi from June to September 2024. It included 847 CALHIV aged 0-19 years who had been on ART for at least 6 months and had at least one available VL result. PRIMARY OUTCOME MEASURE: The rate of USVL among CALHIV, defined as achieving a VL below 1000 copies/mL, in those who had been on ART for at least 6 months.
resultsThe prevalence of USVL among CALHIV was 24.68% (209/847; 95% CI: 21.89% to 27.69%). Multivariable logistic regression analysis revealed that CALHIV with married caregivers were more likely to have USVL (adjsuted OR, aOR=2.4; 95% CI: 1.2 to 5.0). Other factors associated with USVL included horizontal HIV transmission (aOR=2.3; 95% CI: 1.0 to 5.2), advanced WHO clinical stages (aOR=3.5; 95% CI: 1.0 to 13.7), poor/fair ART adherence (aOR=107.8; 95% CI: 50.3 to 231.1) and ART-induced side effects (aOR=3.8; 95% CI: 1.9 to 7.9).
conclusionsThe high rate of USVL among CALHIV in Lubumbashi highlights the need to strengthen ART adherence support, manage treatment side effects and improve early diagnosis and follow-up, particularly for those infected through horizontal transmission or presenting with advanced clinical stages. Special attention should also be given to caregiver-related factors, including marital status, which may influence treatment outcomes.
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