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 Detection of Antiretroviral treatment failure among adult HIV-1 patients on anti-retroviral therapy for 12 +/- 3 months attending different Voluntary Counseling Testing and treatment centers in Khartoum state, Sudan

2020 ◽  
Author(s):  
Nafisa Ahmed Ibrahim ◽  
Khalid A Enan ◽  
Mahdi Mustafa Yagoup ◽  
Wafa Ibrahim Elhag
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Treatment Failure ◽  
Antiretroviral Treatment ◽  
Clinical Staging ◽  
Age Group ◽  
First Line ◽  
Voluntary Counseling ◽  
Hiv 1 ◽  
Antiretroviral Treatment Failure

Abstract Objective: Small number of people on antiretroviral therapy and their virological status in Sudan is lacking. This study aimed to determine the viral load for adult HIV-1 patients who were on antiretroviral therapy for 12+/- 3 months attending different Voluntary Counseling Testing and treatment centers (VCT/ART) in Khartoum state, Sudan.Results: out of 112 adult HIV-1 patients included in this study, only 17.9% (20/112) showed unsuppressed viral load (treatment failure). The majority of them from Omdurman VCT/ART center 80% (16/20), followed by Khartoum VCT/ART center 15% (3/20), Bahri VCT/ART center 5% (1/20) and non from Elban Gadeid VCT/ART center. All of them were on the first line of treatment. Most of them 30% (6/20) on 39-48 years old age group, the majority of them 55%(11/20) on stage 3 WHO clinical staging.

scholarly journals Predictors of Virological Failure and Time to Viral Suppression of First-Line Integrase Inhibitor–Based Antiretroviral Treatment

2020 ◽  
Author(s):  
Ashima Pyngottu ◽  
Alexandra U Scherrer ◽  
Roger Kouyos ◽  
Michael Huber ◽  
Hans Hirsch ◽  
...  
Keyword(s):  
Viral Load ◽  
Treatment Failure ◽  
Viral Suppression ◽  
Cox Regression ◽  
Baseline Viral Load ◽  
Resistance Mutations ◽  
First Line ◽  
Cd4 Counts ◽  
Cell Counts ◽  
The Impact

Abstract Background Integrase strand transfer inhibitors (InSTIs) are recommended for first-line treatment of persons with human immunodeficiency virus (HIV). We identified risk factors, including baseline minor InSTI resistance mutations, for treatment failure of InSTI-based regimens. Methods We studied time-to-treatment failure and time to viral suppression among 1419 drug-naive patients in the Swiss HIV Cohort Study. We performed Cox regression models adjusted for demographic factors, baseline HIV RNA/CD4 cell counts, AIDS-defining events, and the type of InSTI. In 646 patients with a baseline genotypic resistance test of the integrase, we studied the impact of minor integrase resistance mutations. Results We observed 121 virological failures during 18 447 person-years of follow-up. A baseline viral load ≥100 000 copies/mL (multivariable hazard ratio [mHR], 2.2; 95% confidence interval [CI], 1.3–3.6) and an AIDS-defining event (mHR, 1.8; 95% CI. 1.1–3.0) were associated with treatment failure. CD4 counts between 200 and 500 cells/µL (mHR, 0.5; 95% CI, .3–.8) and >500 cells/µL (mHR, 0.4; 95% CI, .2–.7) were protective. Time to suppression was shorter in lower viral load strata (mHR, 0.7; 95% CI, .6–.8) and in dolutegravir-based therapy (mHR, 1.2; 95% CI, 1.0–1.4). Minor resistance mutations were found at baseline in 104 of 646 (16%) patients with no effect on treatment outcome. Conclusions Factors associated with treatment failure on InSTI-based first-line regimen remained similar to those of older treatments, in particular high viral load and low CD4 counts.

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