Despite the central role of caregivers in managing HIV treatment for children living with HIV, viral suppression within caregiver–child dyads in which both members are living with HIV is not well described. The objective of this study was to describe the association between child and caregiver viral suppression and the factors that influence viral non-suppression in children
This retrospective cohort study used electronic medial records for children living with HIV and their adult care-givers living with HIV who received HIV care at the Academic Model Providing Access to Healthcare (AMPATH) program in western Kenya In the multivariable model, children were found more likely to not be virally suppressed if their caregivers were not suppressed compared to children with suppressed caregivers (aOR=2.40, 95% CI: 1.86 to 3.10). Other characteristics associated with child viral non-suppression included caregiver ART regimen change prior to the viral load, care-giver receipt of a non-NNRTI-based regimen at the time of the viral load, younger child age at ART initiation and child tuberculosis treatment at the time of the viral load.
The researchers concluded from this study that children were at higher risk of viral non-suppression if their caregivers were not virally suppressed compared to children with suppressed caregivers. A child’s viral suppression status should be closely monitored if his or her caregiver is not suppressed.