Human Immunodeficiency Viral Treatment in a Tertiary Facility Concerns on Prevalence and Predictors of Viral Load Non Suppression among Children (0-9) and Adolescents (10-19) Attending Clinic, South-West, Nigeria: A Retrospective Study

Background: Despite significant progress made towards achieving theWHO-2030 target particularly African regions, viral load non-suppression (VLNS) especially among children and adolescent remains a substantial challenge in resource limited countries. The introduction HAART has led to a remarkable decrease in global HIV infections, however, the burden of VLNS persists poses a troubling threat to the achievement of the WHO goal at record time. Objective: This study aims to assess the proportion of virological failure and identify predictors of VLNS among children and adolescents receiving antiretroviral treatment (ART) at the Federal Medical Centre, Abeokuta, Southwest Nigeria. Methods: A retrospective cross-sectional analysis of clinical data from pediatric patients aged 0-19 years who attended the Federal Medical Center Abeokuta between January 2021 and December 2023 was conducted. The study focused on both patients with viral load ≥ 1000 copies/ml and those with viral load suppression (≤1000 copies/ml). Results:The mean age was 15.76 ± 3.12 years and majority 41 (30.4%). In 2021, 19 (14.1%) had unsuppressed viral load (VL ≥ 1000 copies/ml). In 2022, unsuppressed viral load was 12 (8.9%) and in 2023, unsuppressed viral load was 16 (11.9%). Compliance to ART was significantly associated with VLNS (P value-0.025) for year 2021, 2022 and 2023 respectively.A multivariate regression analysis of predictors of Viral Load Un-suppression showed that across the 3-years under review – compliance to ART was a strong predictor of non-suppression. Conclusion: In spite of resources and gained made in HIV interventions in achieving viral load suppression, a substantial population of children and adolescent still remain virally unsuppressed; 2021 [14.1%], 2022 [8.9%] and 2023 [11.9%] respectively. This study showed that efforts to achieve UNAIDS 2030 is achievable if compliance to ART can be sustained [p-value- 0.025].