Viral Load Monitoring Outcomes Among HIV-Positive Patients on Antiretroviral Therapy in Nasarawa State

Viral load monitoring is the gold standard for assessing antiretroviral therapy (ART) efficacy and detecting treatment failure in HIV-positive patients. Despite its clinical importance, routine viral load access remains inconsistent across Nigeria's North Central states. This study examines viral load monitoring outcomes among HIV-positive adults on ART at the Federal Medical Centre, Lafia, Nasarawa State. A retrospective cohort study design will extract five years of electronic patient records (2019 to 2024), including baseline CD4 counts, ART regimen type, viral load test frequency, and virological suppression rates. Virological suppression will be defined as plasma HIV RNA below 1,000 copies per millilitre consistent with current Nigeria national guidelines. Statistical analysis will assess predictors of non-suppression and virological failure using logistic regression. Current data from Nigerian ART cohorts indicate suppression rates of 70 to 85 percent, yet significant gaps exist in testing frequency in rural facilities. Findings will characterise virological suppression rates in Nasarawa State, identify subgroups with high rates of non-suppression, and provide recommendations for optimising viral load monitoring protocols at facility level. The study contributes to the Nigeria HIV/AIDS Indicator and Impact Survey data framework and supports the PEPFAR-aligned goal of achieving 95 percent viral suppression among patients on treatment in North Central Nigeria. Keywords: viral load, HIV, antiretroviral therapy, virological suppression, Nasarawa State