Association Between Duration of Antiretroviral Therapy and Virological Suppression Among HIV Patients in South Sulawesi, Indonesia

Cut Indriputri; M. Askar

doi:10.32382/medkes.v20i2.1741

Penulis

Cut Indriputri Bachelor Program in Medical Laboratory Technology, Poltekkes Kemenkes Makassar https://orcid.org/0000-0002-4182-0203
M. Askar Bachelor Program in Medical Laboratory Technology, Poltekkes Kemenkes Makassar

DOI:

https://doi.org/10.32382/medkes.v20i2.1741

Kata Kunci:

HIV, antiretroviral therapy, treatment duration, virological status, viral load

Abstrak

HIV infection remains a major global health problem requiring lifelong therapy to suppress viral replication. Antiretroviral therapy (ART) has been proven effective in reducing viral load; however, its success may vary depending on treatment duration and patient adherence. This study aimed to analyze the relationship between ART duration and virological status among HIV patients receiving first-line ART in South Sulawesi, Indonesia. This descriptive cross-sectional study used medical record data from patients who underwent viral load testing at the referral laboratory in South Sulawesi. A total of 221 patients who had received ART for at least six months were included. The main variables were ART duration (in months) and virological status, categorized as successful (≤1000 copies/mL) or failed (>1000 copies/mL). Data were analyzed descriptively using frequency and percentage distributions. Most patients in all treatment duration groups achieved virological suppression, with success rates ranging from 90% to 100%. Virological failure was observed in 3.6% of patients, particularly in those with treatment durations of 144–166 months. Overall, 96.4% of patients achieved successful virological suppression, meeting the national target, This study demonstrates high rates of virological suppression among HIV patients in South Sulawesi, supporting the effectiveness of first-line ART programs in the region. Routine viral load monitoring and continuous adherence support are essential to sustain long-term treatment success. Future research should include immunological and adherence parameters to provide a more comprehensive evaluation of treatment outcomes.

Referensi

Handoko R, et al. Determinants of suboptimal CD4+ T cell recovery after antiretroviral therapy initiation in a prospective cohort of acute HIV‐1 infection. J Int AIDS Soc. 2020;23(9):e25585. doi: 10.1002/jia2.25585.

Han WM, et al. Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries. Lancet HIV. 2021;8(12):e766-e775. doi: 10.1016/S2352-3018(21)00265-4.

Kurniawan, F, et al. Predictors of Virological Failure in HIV Patients Receiving FirstLine Antiretroviral Therapy with Good Adherence. Jurnal Penyakit Dalam Indonesia. 2017;4(1). doi: 10.7454/jpdi.v4i1.110.

WHO. Consolidated guidelines on HIV prevention, testing, treatment. Geneva: WHO; 2021.

Kementerian Kesehatan RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 87 Tahun 2014 tentang Pedoman Pengobatan Antiretroviral. Jakarta: Kemenkes RI; 2014.

Cohen MS, et al. Early initiation of ART and prevention of HIV-1 transmission. N Engl J Med. 2021;375(9):830-839. doi: 10.1056/NEJMoa1600693

Asare K, et al. Clinical Outcomes After Viremia Among People Receiving Dolutegravir vs Efavirenz-Based First-line Antiretroviral Therapy in South Africa. Open Forum Infect Dis. 2023;10(12). doi: 10.1093/ofid/ofad583.

Esber A, et al. Virologic impact of the dolutegravir transition: prospective results from the multinational African Cohort Study. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2022;91(3):285-289. doi: 10.1097/QAI.0000000000003065.

Kanise H, et al. Virological Findings and Treatment Outcomes of Cases That Developed Dolutegravir Resistance in Malawi’s National HIV Treatment Program. Viruses. 2024; 16(1):29. doi: 10.3390/v16010029.

Arlinda D, et al. HIV viral suppression rate at enrolment, status at one year, and associated factors to non-suppression among outpatient adults at 19 hospitals in Indonesia. International Journal of Infectious Diseases,. 2023;130(2):S126. https://doi.org/10.1016/j.ijid.2023.04.311

Wisaksana R, et al. Risk Factors Associated with Unsuppressed Viral Load in People Living with HIV Receiving Antiretroviral Treatment in Jawa Barat, Indonesia. HIV AIDS (Auckl). 2024;24(16):1-7. doi: 10.2147/HIV.S407681.

Jocelyn J, et al. HIV/AIDS in Indonesia: current treatment landscape, future therapeutic horizons, and herbal approaches. Front Public Health. 2024;12:1298297. https://doi.org/10.3389/fpubh.2024.1298297.

Suryana K, et al. The Impact of Universal Test and Treat Program on Highly Active Anti Retroviral Therapy Outcomes (Coverage, Adherence and Lost to Follow Up) at Wangaya Hospital in Denpasar, Bali-Indonesia: A Retrospective Cohort Study. Open AIDS J. 2021;15:28–34. doi: 10.2174/1874613602115010028.

Pane MR, et al. Quality-of-life changes six months after the programmatic switch from nevirapine to dolutegravir-based ART in stable PLWH: a prospective cohort study in Indonesia. Sci Rep. 2025;15:29604. https://doi.org/10.1038/s41598-025-13931-2.

Qurbonov E, et al. Factors associated with viral load non-suppression among adults with HIV in Sughd region, Tajikistan: a retrospective cohort study. BMC Infect Dis. 2025;900. https://doi.org/10.1186/s12879-025-11270-1

Han WM, et al. Global estimates of viral suppression in children and adolescents and adults on antiretroviral therapy adjusted for missing viral load measurements: a multiregional, retrospective cohort study in 31 countries. Lancet HIV. 2021;8(12):e766-e775. doi: 10.1016/S2352-3018(21)00265-4.

Lundgren JD, et al. INSIGHT Strategic Timing of AntiRetroviral Treatment (START) Study Group. Long-Term Benefits from Early Antiretroviral Therapy Initiation in HIV Infection. NEJM Evid. 2023;2(3):10. doi: 10.1056/evidoa2200302.

Xie Y, et al. Benefits of early ART initiation on mortality among people with HIV. The Lancet HIV. 2022;9(6):e377. doi: 10.1016/S2352-3018(22)00098-4.

Machila N, et al. Prevalence and predictors of virological failure in pediatric patients on HAART in sub-Saharan Africa: a systematic review and meta-analysis. Pan Afr Med J. 2023;22(45):98. doi: 10.11604/pamj.2023.45.98.37017.

Natasya, et al. HIV/AIDS : Update Terkini di Indonesia. Protein: Jurnal Ilmu Keperawatan dan Kebidanan. 2025;3(1):27-36. https://doi.org/10.61132/protein.v3i1.918.

Kiros T, et al. Immuno-virological status and its associated factors among HIV-positive patients receiving highly active antiretroviral therapy at delgi primary hospital, northwest Ethiopia, 2020/2021: A cross-sectional study. Heliyon. 2022;8(8):e10169. doi: 10.1016/j.heliyon.2022.e10169.

Melku M, et al. Immunological status and virological suppression among HIV-infected adults on highly active antiretroviral therapy. Environ Health Prev Med. 2020;25(43). https://doi.org/10.1186/s12199-020-00881-6.

Vanessa AS, et al. Study of suppression of HIV viral load among people receiving antiretroviral therapy in Palembang City. Jurnal Berkala Epidemiologi. 2024;12(3). https://doi.org/10.20473/jbe.V12I32024.273-279.

Martin-Iguacel R, et al. Determinants of long-term survival in late HIV presenters: The prospective PISCIS cohort study. EClinicalMedicine. 2022;52:101600. doi: 10.1016/j.eclinm.2022.101600.

Mou T, et al. Clinical events associated with poor CD4+ T-cell recovery in people living with HIV following ART: A systematic review and meta-analysis. Journal of Infection. 2025;90(2):106414. doi: 10.1016/j.jinf.2025.106414.

Holden CJ, et al. Association of age at antiretroviral therapy initiation with CD4+ : CD8+ ratio recovery among virally suppressed people with HIV. AIDS. 2024;38(5): p703-711. doi: 10.1097/QAD.0000000000003801.

Nicholas P, et al. Pin90 comparative quality of life outcomes of dolutegravir-based or efavirenz-based antiretoviral treatment in pregnancy for late presentors between the 3rd trial-mester and 48 weeks postpartum. Value in Health. 2020;23:s184. doi:10.1016/j.jval.2020.04.553.

Ding H, et al. Outcomes of persistent low-level viremia among HIV patients on antiretroviral therapy: A prospective cohort study. HIV medicine. 2022;23(1):64-71. doi: 10.1111/hiv.13250.