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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
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Detectable HIV Viral Load in Kenya: Data from a Population-Based Survey.
Peter Cherutich1, Andrea A Kim2, Timothy A Kellogg3
1National AIDS/STI Control Programme, Ministry of Health, Nairobi, Kenya.
Plos One
|May 19, 2016
Summary
Most Human Immunodeficiency Virus (HIV)-infected Kenyans (61.2%) had unsuppressed viral loads in 2012. Younger age and not knowing HIV status were linked to higher viral loads, emphasizing the need for better ART access and adherence.
Area of Science:
- Epidemiology
- Public Health
- Virology
Background:
- Human Immunodeficiency Virus (HIV) transmission is significantly reduced by lowering viral load at the individual level.
- Population-level data on HIV viremia are scarce, particularly in high-burden settings with under-diagnosis.
- The 2nd Kenya AIDS Indicator Survey (KAIS 2012) offers insights into antiretroviral therapy (ART) impact on viremia.
Purpose of the Study:
- To evaluate the impact of ART coverage on population-level HIV viremia in Kenya.
- To examine risk factors associated with failure to suppress viral replication among HIV-infected individuals.
- To report on population-level HIV viral load suppression using KAIS 2012 data.
Main Methods:
- The KAIS 2012 surveyed household members, collected questionnaires, and tested serum for HIV.
- Plasma viral load (PVL) was measured for HIV-infected individuals; unsuppressed viremia was defined as PVL ≥ 550 copies/mL.
- Statistical analyses adjusted for survey design and non-response, examining associations with ART use, diagnosis awareness, and adherence.
Main Results:
- Overall, 61.2% of HIV-infected Kenyans aged 15-64 years had unsuppressed viral loads.
- Among those on ART, 26.1% had detectable viremia.
- Non-ART use, younger age, and lack of HIV status awareness were independently associated with higher viral loads; suboptimal adherence was linked to detectable viremia in ART patients.
Conclusions:
- Significant heterogeneity in detectable viral load exists across Kenya's regions.
- Timely ART initiation and retention in care are critical for reducing HIV transmission.
- Geospatial mapping is needed to identify populations at highest risk for targeted interventions.
