Antiretroviral treatment failure and associated factors among HIV patients on first-line antiretroviral treatment in Sekota, northeast Ethiopia

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.

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Magnitude of antiretroviral treatment failure and associated factors among adult HIV-positive patients in Harar public hospitals, Eastern Ethiopia

SAGE Open Medicine ◽

10.1177/2050312120906076 ◽

2020 ◽

Vol 8 ◽

pp. 205031212090607

Author(s):

Rahel Feleke ◽

Biftu Geda ◽

Kedir Teji Roba ◽

Fitsum Weldegebreal

Keyword(s):

Antiretroviral Therapy ◽

Treatment Failure ◽

Associated Factors ◽

Antiretroviral Treatment ◽

Public Hospitals ◽

World Health ◽

Hiv Positive ◽

Therapy Failure ◽

Eastern Ethiopia ◽

Antiretroviral Treatment Failure

Background: Antiretroviral treatment failure occurred when the antiretroviral regimen is unable to control HIV infection. There is no information on antiretroviral therapy failure in this study area. Objective: The aim of this study was to assess the magnitude and associated factors of antiretroviral therapy failure among HIV-positive adult patients in Harar public hospitals from January to February 2018. Methods: An institution-based cross-sectional study was conducted using chart review data from February 2005 to July 2017. Systematic sampling technique was used to include a sample of 1094 patient charts. Data were analyzed by Statistical Package for Social Sciences version 20.0. Statistical significance was considered at p < 0.05. Results: The prevalence of first-line antiretroviral treatment failure was 21% (95% confidence interval = 18.3–23.5). Being male in sex, age of 45–54 years, patients with World Health Organization stages 3 and 4 during antiretroviral therapy initiation, a baseline CD4 count <100 cells/mm3, poor drug adherence, and on antiretroviral therapy follow-up for ⩾25 months were predictors of antiretroviral treatment failure. Conclusion: In this study, the rate of antiretroviral treatment failure is relatively high. Therefore, the concerned body should pay attention to the predictors to reduce the risk of treatment failure among this study group.

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