scholarly journals Factors Associated with First-Line Antiretroviral Therapy Failure amongst HIV-Infected African Patients: A Case-Control Study

2012 ◽  
Vol 02 (04) ◽  
pp. 271-278 ◽  
Author(s):  
Charles M. Kwobah ◽  
Ann W. Mwangi ◽  
Julius K. Koech ◽  
Gilbert N. Simiyu ◽  
Abraham M. Siika
Keyword(s):  
Antiretroviral Therapy ◽  
Case Control Study ◽  
Case Control ◽  
Therapy Failure ◽  
First Line ◽  
Factors Associated ◽  
African Patients ◽  
Control Study

scholarly journals Determinants of Therapy Failure Among Adults on First-line Antiretroviral Therapy in Asmara, Eritrea: A Multicenter Retrospective Matched Case-control Study

2022 ◽  
Author(s):  
Samuel Tekle Mengistu ◽  
Ghirmay Ghebrekidan Ghebremeskel ◽  
Hermon Berhe Ghebrat ◽  
Oliver Okoth Achila ◽  
Nahom Asmerom Yohannes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Case Control Study ◽  
Case Control ◽  
P Value ◽  
People Living With Hiv ◽  
First Line ◽  
Factors Associated ◽  
Control Study

Abstract Background Information on treatment failure (TF) in People living with HIV in data-poor jurisdictions is necessary to counter the rapidly escalating epidemic of TF to first-line combined anti-retroviral therapies (cART) in sub-Saharan Africa (SSA). In this study, we examined the risk factors associated with TF in Asmara, Eritrea.Methods: A multicenter, retrospective 1:2 matched (by age and gender) case-control study was conducted in four major hospitals in Asmara, Eritrea on adults aged >15 years who were on treatment for at least 6 months. Cases were patients with viral load ≥1000 copies/mL anytime between 2019-2021 and/or patients switched to second line cART. Controls were randomly selected from patients on first-line ART with viral load < 1000 copies/mL. Data was extracted using a checklist from the master data set and analyzed using SPSS version 26. Multivariable logistic regression analysis was conducted to identify risk factors for TF. All p-values were 2-sided and the level of significance was set at p < 0.05 for all analyses.Results: Of the 1068 participants, 585 (54.7%) were females. The median age at treatment initiation was 46 years (interquartile range (IQR): 39–51). Median time to combined antiretroviral therapy (cART) failure was 37 months (IQR =24–47). In multivariate analysis factors associated with increased likelihood of virologic failure (VF) were the type of initially used nucleoside reverse transcriptase inhibitors (NRTI) backbone ( (Zidovudine+Lamivudine (AZT+3TC): adjusted odds ratio (aOR): 2.70; 95% Confidence interval (CI): 1.65-4.41, p-value<0.001), (Abacavir+lamivudine (ABC+3TC): aOR: 4.73; 95%CI: 1.18-18.92, p-value=0.028), and (Stavudine+Lamivudine (D4T+3TC): aOR: 5.00; 95% CI: 3.03-8.20, p-value<0.001), prior exposure to ART (aOR: 2.28; 95%CI:1.35–3.86; p=0.002), record of sub-optimal drug adherence (aOR: 3.08; 95%CI: 2.22–4.28; p<0.001), ambulatory/bedridden at presentation (aOR:1.61; 95%CI: 1.12-4.28; p-value=0.010), presence of comorbidities (aOR: 2.37; 95%CI: 1.36-4.10, p-value=0.002), duration of cART (<5 years: aOR: 5.90; 95% CI: 3.95-8.73, p-value<0.001), and use of SMX-TMP prophylaxis ( aOR : 2.00, 95%CI, 1.44-2.78, p-value<0.001). Conclusion: Our findings underscore the importance of optimizing cART adherence, diversification of cART regimens, and interventions directed at enhancing early HIV diagnosis, prompt initiations of treatment and improved patient focused monitoring of treatment response.

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 Determinants of Virologic Failure among Adult HIV Patients on First-Line Antiretroviral Therapy at Waghimra Zone, Northern Ethiopia: A Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Abrham Emagnu ◽  
Zenahebezu Abay ◽  
Abera Balcha Bulti ◽  
Yaregal Animut
Keyword(s):  
Viral Load ◽  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Drug Toxicity ◽  
Case Control Study ◽  
Virologic Failure ◽  
Case Control ◽  
Northern Ethiopia ◽  
Factors Associated ◽  
Control Study

Introduction. The primary goal of antiretroviral therapy (ART) is to reduce the viral load in HIV-infected patients to promote quality of life, as well as to reduce HIV-related morbidity and mortality. A high rate of virologic failure was reported in Waghimra Zone, Northwest Ethiopia, in viral load assessment conducted among HIV-infected patients on ART in the Amhara region. However, there is limited evidence on the determinants of virological failure in the study area. This study aimed to identify the determinants of virological failure among HIV-infected patients on antiretroviral therapy in Waghimra zone, Northern Ethiopia, 2019. Methods. An institutional-based unmatched case-control study was conducted from May 21 to June 30, 2019. Cases were people living with HIV (PLHIV) on ART who had already experienced virological failure; controls were those without virological failure. Data were extracted from 92 cases and 184 controls through chart review using a pretested and structured checklist. The data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. A multivariate logistic regression analysis was carried out to identify factors associated with virological failure, and variables with a P value <0.05 were considered statistically significant. Results. This study revealed that poor adherence to ART (adjusted odds ratio (AOR) = 4.24, 95% confidence interval (CI): 2.17, 8.31), taking ART for longer than five years (AOR = 3.11, 95% CI: 1.17, 8.25), having drug toxicity (AOR = 3.34, 95% CI: 1.54, 7.23), age of PLHIV ≥ 35 years (AOR = 2.45, 95% CI: 1.29,4.64), and recent CD4 count <200 cells/mm³ (AOR = 3.06, 95% CI: 1.52, 6.13) were factors associated with virologic failure. Conclusion and Recommendation. This study showed that poor adherence to treatment, longer duration on ART, experiencing drug toxicity, older age, and recent CD4 <200 cell/mm³ are factors that increase the risk of virologic failure.

scholarly journals Predictors of the Occurrence of Tuberculosis in HIV-infected Adults during the First Six Months of Antiretroviral Therapy in Kisangani, DR Congo

2020 ◽  
pp. 28-33
Author(s):  
Dieudonné Lobela Bumba ◽  
Issa Yakusu Issa ◽  
Daniel Kazadi Musakayi ◽  
Floribert Olinda Loku ◽  
Jacques Ossinga Bassandja ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Predictive Factors ◽  
Case Control Study ◽  
Case Control ◽  
Dr Congo ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
The City ◽  
The Town ◽  
Control Study

Objective: To determine the predictive factors for the occurrence of tuberculosis (TB) in adults infected with the human immunodeficiency virus (HIV) during the first 6 months of antiretroviral therapy (ART) in Kisangani. Methods: A case-control study was carried out during the period from January 1, 2017 to December 31, 2018. Clinical data were collected retrospectively from patients receiving antiretroviral therapy in the city of Kisangani. Of a total of 1,161 HIV-infected patients included in this study, 58 of them developed TB. The diagnosis of tuberculosis was made on the presence of Acid-Alcohol-Resistant Bacile (BAAR) on at least one biological sample or on the basis of a bundle of clinical and paraclinical arguments. This test is done during the first six months of initiating anti retroviral therapy (ART). Predictive factors for the onset of TB in these patients on antiretroviral therapy were identified using logistic regression analysis. Results: After multivariate analysis, the independent factors associated with the onset of TB were: being married (OR = 4.456; 95% CI: 1.061-18.713), residence in the town of Tshopo (OR = 7.04; 95% CI: 1.168-42.47) as well as stages 3 and 4 of AIDS disease (OR = 29 95% CI: 4.563-184.872 and OR = 50.8 95% CI: 3.971-680.995). Conclusion: The results found by this study highlight the need for active TB testing in HIV-infected individuals. Particular emphasis should be placed on the category of patients on antiretroviral therapy who have one of the independent factors for the onset of TB.

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