More than 14.5 of the 36.7 million individuals living with HIV all over the world don't have the clear idea about their HIV status, so making exhaustive testing intervention a basic step in closure the HIV/AIDS epidemic (1).
Sudan is one of the areas that enclosed by countries with higher rate of HIV infection. The prevalence was 1.6% in 2002 (2). As indicated by UNAIDS 2011, the prevalence was diminished to 0.4% after South Sudan dissociation. In 2018 it was diminished to 0.2%.(3)
In Sudan, 2018, adults living with HIV were 55000, among them, only 9000 (15%) were on antiretroviral therapy (ART) and no data about people living with HIV who have suppressed viral loads (3)
In areas with satisfactory resources, research center estimations of CD4 + T cells and plasma HIV viral load are usually used to build up a patient's level of immunosuppression and the rate of destruction of the immune system, these are used to ascertain a patient’s eligibility for treatment and also monitor disease progression (4). In resource limited areas in which deficient settings to test CD4 + T cells and plasma HIV viral load, clinicians depend on the clinical parameters while assessing a patient's disease status.
HIV-1 viral load testing is an essential part of HIV-1 management in the world, both before and during antiretroviral therapy (5). The amount of virus present in the plasma affects clinical decisions; therefore, accurate sensitive viral load assays are very important.
Monitoring HIV viral load in people living with HIV is essential to maintain effective individual antiretroviral therapy as well as monitoring progress toward achieving population targets for viral suppression(6). It is an excellent predictor of survival to AIDS and death(7, 8) with a better correlation and independent of CD4 count(9, 10).
Viral loads exceeding 50 copies/ml always need further investigations, and > 1,000 copies/ml (> 3 log copies/ml) is considered to be the threshold for resistance testing(11, 12) and in this case, the WHO recommends a confirmatory viral load measurement 3 months after the first viral load and enhanced adherence support, with switch to second-line ART contingent upon a continued elevated viral load(13). Without drug resistance, HIV-positive patients should achieve viral suppression within 8–24 weeks after ART initiation(14, 15)
In 2014 the Joint United Nations Program on HIV and AIDS (UNAIDS) set a determined target known as the 90-90-90, that indicated that by 2020, 1) 90% of all HIV positive people will be diagnosed, 2) 90% of all those diagnosed will be on treatment and 3) 90% of those linked to care will be virally suppressed.(16)
So this study aimed to estimate the viral load for adult HIV-1 patients who were on antiretroviral therapy for 12 +/- 3 months attending different Voluntary Counseling Testing and treatment centers (VCT/ART) in Khartoum state, Sudan.