First-line antiretroviral treatment failure and associated factors in HIV patients at University of Gondar Teaching Hospital, Gondar, Northwest 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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Characterization of human immunodeficiency virus-infected patients of suspected first-line antiretroviral treatment failure within 5 years – Evidence from a tertiary hospital, Kolkata

Indian Journal of Sexually Transmitted Diseases and AIDS ◽

10.4103/ijstd.ijstd_81_18 ◽

2019 ◽

Vol 40 (2) ◽

pp. 159

Author(s):

Dolanchampa Modak ◽

Nivedita Dutta ◽

Shantasil Pain ◽

Rajyasree Ghosh (De) ◽

SubhasishKamal Guha

Keyword(s):

Human Immunodeficiency Virus ◽

Treatment Failure ◽

Antiretroviral Treatment ◽

Tertiary Hospital ◽

First Line ◽

Immunodeficiency Virus ◽

Antiretroviral Treatment Failure

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

SAGE Open Medicine ◽

10.1177/20503121211030182 ◽

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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