TITLE:
Effect of the COVID-19 Pandemic on HIV-1 Viral Load Monitoring among Patients on ART at INSP, Guinea, 2014-2024
AUTHORS:
Penda Maladho Diallo, Mamadou Bobo Diallo, Almamy Amara Toure, Ibrahima Gouressy, Talla Nioke, Gbawa Camara, Jeannette Niami, Roger Soua Camara, Mariame Diawara, Alpha Mamadou Sylla, Goboune Lamah, Adama Cissé, Kaba Kourouma, Houssaïnatou Bah, Mahamoud Sama Cherif
KEYWORDS:
HIV Viral Load, Virological Failure, Antiretroviral Therapy (ART), COVID-19 Impact
JOURNAL NAME:
World Journal of AIDS,
Vol.15 No.4,
December
31,
2025
ABSTRACT: Therapeutic monitoring of people living with HIV (PLHIV) relies mainly on HIV viral load (VL) measurement. This study evaluated the impact of the COVID-19 pandemic on HIV-1 viral load testing among PLHIV on antiretroviral therapy (ART) at the National Institute of Public Health (INSP) in Guinea from 2014 to 2024. Methods: A retrospective cross-sectional study was conducted at the HIV/Hepatitis Molecular Biology Laboratory of INSP on 29,529 samples from PLHIV. Viral load was measured by real-time PCR using NorDiag/HAIN and Abbott platforms. Data were analyzed with R software. Virological failure was defined as a VL ≥ 1000 copies/mL. Results: A marked improvement in virological control was observed over time, increasing from 77.5% before the COVID-19 pandemic to 88.8% after, with a decrease in failure rates from 22.5% to 11.2%. Most samples were from women (72.8%) and adults aged 18-49 years. The average treatment duration increased from 3.9 to 6.3 years between the two periods. Health centers became the main referring structures post-pandemic, reflecting increased decentralization. Multivariate analyses showed that men, individuals under 18 years, and patients followed in university hospitals before the pandemic had a higher risk of virological failure. Conversely, patients followed in NGOs or health centers during the pandemic had better outcomes. Adult age, longer treatment duration, and first-line follow-up were associated with better viral suppression. Conclusion: The results reveal improved virological monitoring in Guinea despite disruptions caused by the pandemic. However, persistent inequalities call for targeted interventions to improve equity and achieve UNAIDS viral suppression targets.