scholarly journals Time to First-Line Antiretroviral Treatment Failure and Its Predictors among HIV-Positive Children in Shashemene Town Health Facilities, Oromia Region, Ethiopia, 2019

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Endale Zenebe ◽  
Assefa Washo ◽  
Abreham Addis Gesese
Keyword(s):  
Treatment Failure ◽  
Survival Time ◽  
Median Survival ◽  
Virological Failure ◽  
Median Survival Time ◽  
Antiretroviral Treatment ◽  
Health Facilities ◽  
Incidence Density ◽  
First Line ◽  
Antiretroviral Treatment Failure

With expanding pediatric antiretroviral therapy access, children will begin to experience treatment failure and require second-line therapy. In resource-limited settings, treatment failure is often diagnosed based on the clinical or immunological criteria which occur way after the occurrence of virological failure. Previous limited studies have evaluated immunological and clinical failure without considering virological failure in Ethiopia. The aim of this study was to investigate time to first-line antiretroviral treatment failure and its predictors in Shashamene town health facilities with a focus on virological criteria. Methods. A retrospective cohort study was conducted in three health facilities of Shashamene town, Oromia Regional State, from March 1 to 26, 2019. Children aged less than 15 years living with HIV/AIDS that were enrolled on ART between January 1, 2011, and December 30, 2015, in Shashamene town health facilities were the study population. Data were extracted using a checklist, entered into EpiData version 3.1, and exported to SPSS version 20 for data analysis. Cox proportional hazard regression was used to determine the predictors of time to first-line treatment failure. Result. The median survival time to virological failure was 30 months with IQR of 24.42 to 44.25. Baseline WHO stages 3 and 4 with AHR = 5.69 (95% CI: 2.07–15.66) and NVP-based NNRT at initial treatment with AHR = 2.72 (1.13–6.54) were the independent predictors of time to treatment failure. Conclusion. The median survival time of first-line antiretroviral treatment failure was moderate in the study area as compared to other studies. The incidence density of treatment failure in this study was low as compared to other studies. The finding also demonstrated that children treated with nevirapine-based nonnucleoside reverse transcriptase inhibitors at initial and advanced WHO clinical stages at baseline were at higher risk of treatment failure.

scholarly journals Increased viral suppression among people on first line antiretroviral treatment in Ethiopia: Meeting the third 90’s

2020 ◽  
Author(s):  
Minwuyelet Maru ◽  
Daniel Dagne ◽  
Addisu Tesfie ◽  
Asefa Missaye ◽  
Gizachew Yismaw ◽  
...  
Keyword(s):  
Viral Load ◽  
Treatment Failure ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Treatment Initiation ◽  
Complete Suppression ◽  
Amhara Region ◽  
First Line ◽  
North East ◽  
Antiretroviral Treatment Failure

Abstract Background Antiretroviral treatment (ART) is aimed for complete suppression of viral replication but it fails for a variety of reasons. The aim of this study was to determine the prevalence and associated factors of treatment failure among people on first line ART in Amhara region, North east Ethiopia.Methods A cross sectional study was conducted from March, 2018 to July, 2018. Questionnaire survey using a pre-structured questionnaire was taken focusing on demographic data and possible risk factors of antiretroviral treatment failure. Clinical history including baseline characteristics was extracted by reviewing medical records using data abstraction sheet and data was analyzed using STATA version 14.Results A total of 640 clients of all age from 16 health facilities were enrolled in the study. The overall antiretroviral treatment failure was 16.45% from which clinical, immunologic and virologic failure were 0.47%, 13.59% and 3.13% respectively. The viral suppression was 91.09%, but more than half, 29 (50.88%) study participants with high first viral load (>1000copies/ml) were defaulted and not tested for the 2 nd viral load testing. Binary and multivariable logistic regression analysis showed significance association of treatment failure with age at treatment initiation (OR, 1.029), duration on ART (OR, 0.87) and adherence (AOR, 4.22). High proportion of treatment failure was also found in females (62.75%) and in those below primary education (76.47%).Conclusions In conclusion increased viral suppression is observed but the rate of default during 3 month of enhanced adherence counseling is high. The overall magnitude of treatment failure in Amhara region is 16.45%. Fair/poor adherence, older age at treatment initiation and shorter duration on ART are significantly independent factors of treatment failure. Therefore improving client follow up to adherence to treatment should be strengthened.

scholarly journals Determinants of first-line antiretroviral treatment failure among adult HIV patients at Nekemte Specialized Hospital, Western Ethiopia: Unmatched case-control study

2021 ◽  
Vol 9 ◽  
pp. 205031212110301
Author(s):  
Mengistu Desalegn ◽  
Dejene Seyoum ◽  
Edosa Kifle Tola ◽  
Reta Tsegaye Gayesa
Keyword(s):  
Confidence Interval ◽  
Treatment Failure ◽  
Support Group ◽  
Odds Ratio ◽  
Antiretroviral Treatment ◽  
Adjusted Odds Ratio ◽  
P Value ◽  
First Line ◽  
Specialized Hospital ◽  
Antiretroviral Treatment Failure

Objective: In Ethiopia, only a few studies were conducted to determine factors contributing to antiretroviral treatment failure, in general, and there are no published data in the study area, in particular. Thus, the aim of the study was to assess the determinants of first-line treatment failure among adult HIV patients on antiretroviral treatment at Nekemte Specialized Hospital, western Ethiopia. Methods: The hospital-based 1:2 unmatched case–control study was conducted in Nekemte Specialized Hospital from 1 August to 30 September, 2019, on 252 HIV-positive patients receiving antiretroviral treatment (86 cases and 166 controls). Cases were selected from patients who were switched to second-line antiretroviral treatment regimen after first-line antiretroviral treatment failure. Controls were from those who are on the first-line antiretroviral regimens for at least 6 months. Data were collected by two trained clinical nurses. Record review and an interviewer-administered questionnaire were used to collect data. Data were entered into Epi-Data, version 7.2.2, and then exported to SPSS, version 25, for analysis. The association between treatment failure and each covariate was assessed by bivariate analysis to identify candidate variables at p value < 0.25. All candidate variables were entered into multivariate analysis done in stepwise backward likelihood ratio to declare statistical significance association at p value < 0.05, 95% confidence interval. Results: Data from a total of 252 (86 cases and 166 controls) patients were extracted at a response rate of 98.4%. Statistically higher odds of first-line treatment failure were observed among those who started treatment at an advanced stage (Baseline World Health Organization stage 3 o r4 (adjusted odds ratio = 3.12, 95% confidence interval: 1.55–6.26), lower Baseline CD4 count < 100 cells (adjusted odds ratio = 3.06, 95 % confidence interval: 1.45–6.50), lack of participation in a support group (adjusted odds ratio = 4.03, 95% confidence interval: 1.98–8.21), history of antiretroviral treatment discontinuation for greater than 1 month (adjusted odds ratio = 2.36, 95% confidence interval: 1.17–4.78) and poor adherence to antiretroviral treatment (adjusted odds ratio = 3.09, 95% confidence interval: 1.54–6.19). Conclusion: Antiretroviral treatment initiation at an advanced stage, lower CD4 count, no participation in a support group, and poor adherence were determinants of treatment first-line antiretroviral treatment failure. Therefore, health care providers and program developers should give special attention to; early diagnosis and start of treatment, encouraging patients to participate in a support group, trace patients early, and attentively follow patients to improve their adherence to antiretroviral treatment.

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