Art experience, VL suppression, and CD4 status of HIV patients admitted to Homabay County Hospital inpatient department in 2021

Abstract

Background: Despite advancements in antiretroviral therapy (ART) uptake, AIDS-related morbidity has increased in recent years, and  those living with advanced HIV disease face a greater risk of death. Advanced HIV is usually associated with ART treatment failure,  treatment interruptions, and late diagnoses. We did an assessment in the Homabay County inpatient department to check ART use, Viral Load (VL) suppression and CD4 status among patients admitted to IPD in 2021

Methodology: We retrospectively abstracted records of  PLHIV on ART admitted in the medical wards at HCTRH, Homa Bay County in Kenya from January to December 2021. Sociodemographic  and clinical variables were abstracted from Ministry of Health registers into a database with enforced data quality and consistency  checks. We conducted descriptive data analysis and assessed ART use, viral load suppresion and CD4 status of patients.

Results: A total of  1007 HIV-positive patients were admitted in 2021. The mean age was 42 with an SD of 14.7. Females HIV positive were 54% (540/1007).  Previous ART use was confirmed in 71% (713/1007) of the patients and 3% (32/1007) being ART Naïve. Missing ART documentation in 26%  (261/1007) of the patients. Viral load and CD4 uptake in the IPD was 589(58%). Of the patients done VL, 71%(346/589) were LDL, 8%  (50/589) had low-risk LLV, 7% (39/589) had highrisk LLV and 26% (154/589) had VLs >1000copies.CD4 < 200 was identified in 31% of LDL  Clients, 56% of low-risk LLVs, 54% of high-risk LLVs, and 78% of patients with VL> 1000 copies

Conclusion: About three-quarters of HIV- positive patients admitted to IPD in 2021 were ART experienced and more than half of the patients done viral load were suppressed.  Three in every ten patients who had LDL VL had a CD4 less than 200. We recommend the need to track patient CD4 in the wards to help in  identifying advanced HIV patients.