Antiretroviral therapy regimens associated with viral suppression in adolescents on HIV treatment in Kenya

Introduction:According to 2021 UNAIDS report, there were approximately 99,159 adolescents living with human immunodeficiency virus (HIV) in Kenya, with a viral suppression rate of 67% [1].There are limited studies in Kenya on the types of regimens associated with viral suppression among adolescents.Therefore, this study aimed to determine the antiretroviral therapy (ART) regimens associated with viral load suppression in adolescents on ART. Material and methods:A retrospective cross-sectional analysis of 38,503 HIV-infected adolescents (age range, 10-19 years) receiving ART for at least 6 months with a documented viral load, was conducted.Data analyzed were Kenyan HIV program data obtained from electronic medical records of HIV-positive patients from January 2018 till December 2022. Results:The viral suppression rate was 81.2%, distinctly higher than the 2021 UNAIDS estimate of 67% and the national suppression rate of 75% (2022).The highest viral suppression was found in the lamivudine (3TC) + dolutegravir (DTG) + tenofovir disoproxil fumarate (TDF) regimen (86.4%), followed by lamivudine (3TC) + abacavir (ABC) + dolutegravir (DTG) (81.6%) (AOR = 0.57, 95% CI: -0.52 to 1.65).Lamivudine (3TC) + atazanavir/ritonavir (ATV/r) + tenofovir (TDF) exhibited a viral suppression of 70.1% (AOR = 0.4, 95% CI: -0.34 to 0.45), lamivudine (3TC) + ritonavir/atazanavir (ATV/r) + zidovudine (AZT) had viral suppression of 62.7% (AOR = 0.28, 95% CI: -0.24 to 0.32), while lamivudine (3TC) + zidovudine (AZT)+ lopinavir/ritonavir (LPV/r) was found with 62.2% rate (AOR = 0.23, 95% CI: -0.21 to 0.26), lamivudine (3TC) + zidovudine (AZT) + dolutegravir (DTG) with 58.7% (AOR = 0.2, 95% CI: -0.17 to 0.22), and lamivudine (3TC) + abacavir (ABC) + lopinavir (LPV/r) with 56.4% (AOR = 0.18, 95% CI: -0.16 to 0.20). Conclusions:The viral suppression rate for adolescents was 81.2%.It is crucial to expedite treatment optimization for youths with non-optimal regimens to prevent treatment failure and ensure achieving the UNAIDS target of 95%.A comprehensive examination of viral suppression rates for adolescents on protease inhibitors is essential with consideration of shifting to optimal regimens, thereby improving treatment outcomes.