Factors Associated with the Unsuppressed Viral Load of Children on Antiretroviral Therapy Followed Up in the GbêkêRegion (Côte d’Ivoire)

Introduction: Unsuppressed viral load (VL) in immunocompromised children on antiretroviral therapy (ART) increases the risk of child morbidity and death. The aim of the study was to identify factors associated with unsuppressed viral load in children on ART for the improvement of prognosis. Patients and Methods: this is a retrospective, descriptive and analytical study carried out from July 2015 to December 2019 in the 28 pediatric HIV/AIDS treatment centers supervised by the NGO IRAA in the region of Gbêkê. It Included children from 0 to 15 years who were HIV positive, on ART for at least 6 months with at least one viral load. The variables studied were socio-demographic, diagnostic and evolutionary. Data analysis was descriptive and analytical with a significance level of p < 0.05. Results: out of 329 children included, 118 (62 boys, 53 girls) had a non-suppressed VL, i.e. a prevalence of 36%. The mean age at diagnosis was 61 months. The mother was a small trader (36.4%), illiterate (45.8%). Unsuppressed viral load was significantly associated with poor nutritional status at the start of treatment (p < 0.001), non-compliance with treatment (p < 0.001), poor maternal education (p = 0.011) and the lack of follow-up of the mother in the context of PMTCT (p = 0.03). Conclusion: Unsuppressed viral load is common in children on ART in the Gbêkê region. It mainly concerns the child who did not comply with ART, and whose mother was not followed within the framework of PMTCT. Strengthening early detection, early initiation of ART, PMTCT and increased therapeutic education strategies would improve the prognosis of children infected with HIV.