Comparative Assessment of Viral Load Suppression Rate among Treatment-naive and Treatment-experienced Patients with Advanced Human Immunodeficiency Virus Disease in Benue state, Nigeria

Abstract Background: Overall, Benue state has attained the Joint United Nations Programme on human immunodeficiency virus (HIV)/AIDS (UNAIDS) 95-95-95 target, placing it on the verge of HIV epidemic control. However, gaps remain in achieving 95% viral suppression by the Advanced HIV Disease (AHD) subpopulation. Aim: This study compares the proportion of treatment-naive and treatment-experienced clients with AHD in Benue State. It also determines the viral load suppression rate and its predictors among treatment-naive and treatment-experienced clients with AHD in the State. Materials and Methods: This was a hospital-based, retrospective and comparative cross-sectional study of all HIV-infected people with AHD who were receiving antiretroviral therapy (ART) services in Benue State between 1 October 2020 and 30 September 2023. Results: Of the 160 randomly selected participants for analysis, the median age was higher among ART-experienced clients, 38 years versus 35.5 years (interquartile range: 25–43) and 106 (66.3%) were females. Most clients who are ART naïve or ART-experienced and achieved viral suppression (86.3% vs. 90.0%) were similar in age, sex and marital status. In multivariable analysis, only adolescents showed a statistically significant association with viral load suppression in ART naïve clients compared to ART-experienced clients (adjusted OR 17.24; 95% confidence interval, 1.36–219.16; P = 0.03). Conclusion: This study highlights the necessity for targeted interventions to improve retention and viral load suppression, especially for those newly diagnosed with AHD. Sustaining the progress in the HIV program will require robust, age-specific and person-centred strategies that focus on enhancing the treatment outcomes.