Plasma CD4 Count and Duration ARV as a Predictor of Virological Failure Amongst AIDS Patients

Abstract

Background: The 90-90-90 strategy to overcome the HIV/AIDS (Human Immunodeficiency Virus/Acquired
Immunodeficiency Syndrome) epidemic in the world still has challenges because 20% of people live with
HIV/AIDS (PLWHA) received anti retroviral (ARVs) are at risk of virological failure. This study describes
and analyzes the factors that influence the occurrence of virological failure in AIDS patients who have taken
ARVs.
Method: A hospital based cross-sectional study and retrospective medical record review in Dr. Soetomo
Teaching Hospital Surabaya from January 2017 until December 2018. Virological failure is plasma viral
load greater than 1000 copies/ml.
Result: According to data analysis for each variable, we used a CD4 (Cluster of Differentiation) cut-off
of 134 cells/?l and ? 20.5 months for virological failure. There was a statistically significant relationship
between CD4 cell count 95% CI (1.33-11,281) p 0.010 and duration of ARV (1,396-11.78) 95% CI p 0.01.
Summation of total score from both variables has a p value <0.001 which means the total score of the two
variables is significant as a predictor of virological failure. The total area of the ROC curve is 73.6% with a
sensitivity of 81.5% and specificity of 44.4%.
Conclusion: The duration of ARV consumption and CD4 cell count have an effect and can be an initial
evaluation of the occurrence of virological failure.