scholarly journals Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

2021 ◽  
Vol Volume 13 ◽  
pp. 1035-1044
Author(s):  
Awoke Shumetie ◽  
Nurilign Abebe Moges ◽  
Muluken Teshome ◽  
Getnet Gedif
Keyword(s):  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Amhara Region ◽  
First Line ◽  
West Gojjam ◽  
West Gojjam Zone

scholarly journals Faktor Prediktor Kegagalan Virologis pada Pasien HIV yang Mendapat Terapi ARV Lini Pertama dengan Kepatuhan Berobat Baik

2017 ◽  
Vol 4 (1) ◽  
pp. 29
Author(s):  
Farid Kurniawan ◽  
Samsuridjal Djauzi ◽  
Evy Yunihastuti ◽  
Pringgodigdo Nugroho
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Clinical Stage ◽  
World Health ◽  
Weight Changes ◽  
First Line ◽  
Hiv Patients ◽  
Good Adherence ◽  
Study Results

Pendahuluan. Pada negara dengan keterbatasan sumber daya, pengukuran viral load (VL) sebagai prediktor efektivitas terapi antiretroviral (ARV) tidak selalu mudah untuk diakses oleh pasien HIV yang mendapat terapi ARV. Pada penelitian-penelitian sebelumnya, kepatuhan berobat (adherens) diketahui merupakan faktor penting terhadap supresi VL HIV. Penelitian ini bertujuan untuk mengetahui faktor prediktor kegagalan virologis pada pasien HIV yang mendapat terapi ARV lini pertama sesuai paduan ARV terbaru dengan kepatuhan berobat yang baik di Indonesia.Metode. Studi kohort retrospektif dilakukan pada pasien HIV rawat jalan dewasa di Rumah Sakit dr. Cipto Mangunkusumo (RSCM), Jakarta yang memulai terapi ARV lini pertama selama periode Januari 2011-Juni 2014. Pasien HIV dengan kepatuhan berobat baik yang mempunyai data VL 6-9 bulan setelah mulai terapi ARV dimasukkan sebagai subjek penelitian. Kegagalan virologis dinyatakan sebagai nilai VL ≥400 kopi/mL setelah minimal 6 bulan terapi ARV dengan kepatuhan berobat baik. Usia awal terapi ARV, faktor risiko penularan HIV, stadium klinis HIV menurut World Health Organization (WHO), koinfeksi HIV-TB, jumlah CD4 awal terapi, peningkatan jumlah CD4, kadar hemoglobin dan indeks massa tubuh awal terapi, perubahan berat badan selama terapi, dan basis paduan terapi ARV merupakan variabel yang diteliti pada penelitian ini.  Hasil. Terdapat 197 pasien sebagai subjek penelitian ini. Kegagalan virologis ditemukan pada 21 pasien (10,7%). Peningkatan CD4 <50 sel/mm3 setelah minimal 6 bulan terapi merupakan prediktor kegagalan virologis (p = 0,003; OR 5,802, 95% CI= 1,842-18,270). Terdapat peningkatan risiko kegagalan virologis pada pasien dengan terapi ARV berbasis NVP pada saat VL diperiksa, namun tidak bermakna secara statistik (p = 0,060; OR 2,756; 95% CI= 0,958-7,924). Simpulan. Peningkatan CD4 <50 sel/mm3 setelah minimal 6 bulan terapi dapat memprediksi kegagalan virologis pada pasien yang mendapat terapi ARV lini pertama dengan kepatuhan berobat yang baik. Kata Kunci: kegagalan virologis, terapi ARV lini pertama, viral load Predictors of Virological Failure in HIV Patients Receiving First Line Antiretroviral Therapy with Good AdherenceIntroduction. Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate success or failure of ART. However, in country with limited resources, viral load measurement is not easily accessible by HIV patients receiving ART. Therefore, it is necessary to know which factors that can predict virological failure. In previous studies, adherence was an  important factor for suppression of HIV viral load.  This study is aimed to know predictors of virological failure in HIV patients receiving recent first line ART regimen with good adherence in Indonesia. Methods. A retrospective cohort study was conducted among adult HIV patients in Out-patient Clinic of Cipto Mangunkusumo Hospital that started ART during periode of  January 2011-June 2014. HIV patients with good adherence that had viral load data 6-9 months after initiation of ART were included in this study. Virological failure was defined as viral load ≥ 400 copies/mL after minimum of 6 months therapy with good adherence. Age at starting ART, risk factor for HIV infection, HIV clinical stage, HIV-TB co-infection, baseline CD4 value, CD4 count increase, baseline hemoglobin level and body mass index, weight changes during therapy, and ART based regimen were analyzed in this study. Results. A total of 197 patients were included in this study. Virological failure was found in 21 patients (10,7%). CD4 increase <50 cell/mm3 after minimum 6 months of ART was predictor of virological failure (p = 0,003; OR 5,802, 95%CI 1,842-18,270). Conclusion. CD4 increase <50 cell/mm3 after minimum 6 months therapy can predict virological failure in HIV patients receiving first line ART with good adherence.  

scholarly journals Determinants of virological failure among adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia: a case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036223
Author(s):  
Habtamu Mengist Meshesha ◽  
Zelalem Mehari Nigussie ◽  
Anemaw Asrat ◽  
Kebadnew Mulatu
Keyword(s):  
Public Health ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Highly Active Antiretroviral Therapy ◽  
Case Control Study ◽  
Case Control ◽  
First Line ◽  
Highly Active ◽  
Northeast Ethiopia ◽  
Control Study

ObjectiveTo identify determinants of virological failure among HIV-infected adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia, in 2019.MethodsAn unmatched case–control study was conducted from April to May 2019. About 130 cases and 259 controls were selected by simple random sampling. Data were extracted from charts of patients using a structured checklist. Multiple logistic regression analysis was performed to identify possible factors. Hosmer-Lemeshow goodness of fit test was used to check the model. Finally, independent predictor variables of virological failure were identified based on adjusted OR (AOR) with 95% CI and a p value of 0.05.ResultsThe odds of virological failure were 2.4-fold (AOR=2.44, 95% CI 1.353 to 4.411) higher in clients aged <35 years compared with older clients, fivefold (AOR=5.00, 95% CI 2.60 to 9.63) higher in clients who did not disclose their HIV status, threefold (AOR=2.99, 95% CI 1.33 to 6.73) higher in clients with poor adherence, and 7.5-fold (AOR=7.51, 95% CI 3.98 to 14.14) higher in clients who had recent CD4 count of ≤250 cells/mm3.Conclusion and recommendationThis study revealed that age, marital status, occupation, disclosure status, baseline functional status, missed clinic visit, current antiretroviral therapy regimen, adherence to treatment and recent CD4 count were significantly associated with virological failure. Therefore, adherence support should be strengthened among clients. Missed clinic visits should also be reduced, as it could help clients better adhere to treatment, and therefore boost their immunity and suppress viral replication.

scholarly journals Evolution of HIV-1 drug resistance after virological failure of first-line antiretroviral therapy in Lusaka Zambia

2019 ◽  
Vol 24 (4) ◽  
pp. 291-300
Author(s):  
F Parker Hudson ◽  
Lloyd Mulenga ◽  
Andrew O Westfall ◽  
Ranjit Warrier ◽  
Aggrey Mweemba ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
First Line ◽  
Hiv 1

scholarly journals Magnitude and Factors Affecting Virological Treatment Failure among HIV Reactive Adults from Selected Hospitals of North Shoa Zone, Amhara Region, Ethiopia

2020 ◽  
Author(s):  
Behailu Tariku Derseh ◽  
Belay Shewayerga ◽  
Abinet Dagnaw ◽  
Elyas Admasu Basha
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Therapy ◽  
Treatment Failure ◽  
Virologic Failure ◽  
Drug Adherence ◽  
Amhara Region ◽  
First Line ◽  
Study Participants ◽  
Virological Treatment Failure

Abstract Background Nowadays Human Immuno-deficiency Virus (HIV) is one of the devastating and prevalent viruses affecting the globe without a cure. Highly Active Antiretroviral Therapy (HAART) significantly reduced the morbidity and mortality of patients with HIV infection. Although there is increasing global use of antiretroviral therapy (ART) for the treatment of HIV/AIDs, the global trends in ART failure are growing. In developing countries including Ethiopia, particularly in our study settings, information related to the magnitude and correlates of virological treatment failure is scarce. Thus, this study aimed at assessing the magnitude of virological treatment failure and associated factors among HIV reactive adults at selected hospitals of North Shoa, Amhara Region, Ethiopia. Methods a facility-based cross-sectional study was conducted among 498 study participants who started their first-line HAART from August 2005 to December 2018. Data were collected from patients’ charts and face-to-face interviews using a structured questionnaire. The bivariable analysis was executed to select candidate predictor variables at a p-value of less than 0.2. Multivariable logistic regression (forward stepwise, conditional) analysis was used to identify factors associated with virologic failure at a significant level of 5%. Model adequacy check was done by Hosmer and Lemeshow (p = 0.57) and Naglkerke R Square (0.46) was calculated to express the variability of virological failure by predictors. Result More than half 290 (58.2%) of the study participants were females. The median age at ART initiation was 40 years with an interquartile range (IQR) of 15 years. The median duration of virologic failure since initiation of treatment was 96 months (IQR) of 72. The magnitude of virological treatment failure was 10.24% (95% CI: 7.57% − 12.91%). Poor ART drug adherence (AOR = 4.54; 95% CI: 2.09, 9.87), CD4 count less than 250 cell/µl (AOR = 24.88; 95% CI: 11.73, 52.81) and Poor Quality of Life (QoL) (AOR = 2.65; 95% CI: 1.12, 6.25) were independent predictors of virologic failure. Conclusion The magnitude of Virologic ART treatment failure in this study was relatively high. Poor ART drug adherence, patients’ having lower CD4 count and poorer quality of life were predictors of treatment failure. Thus, an intervention programs that enriches patients’ health-related quality of life should be implemented. Moreover, counseling that supplements the importance of drug adherence and reduction of risks that lower CD4 counts should be given emphasis which in turn helps to prevent first-line ART treatment failure.

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