Antiretroviral treatment failure among HIV-positive adults taking first-line therapy and associated risk factors at Adigrat General hospital, Adigart, Ethiopia 2019: A cross sectional study

Abstract

BackgroundHuman Immunodeficiency Virus (HIV) is a major public health problem globally. Highly active antiretroviral therapy (HAART) has led to profound reduction in the incidence of mortality. However, effective treatment is challenged by the treatment failure. Anti-Retroviral Treatment (ART) Failure may predispose patients to new or recurrent clinical condition. ObjectiveThis study was designed to assess virological and immunological failure of highly active antiretroviral therapy users and associated risk factors at Adigrat General Hospital, Adigrat, Ethiopia. MethodsInstitutional based retrospective cross sectional study was conducted. Data were collected by pre-tested structured checklist. The data were entered into Epi-info version 7 and exported into SPSS version 22.0 for analyses. The association between variables was analyzed using multivariate binary logistic regression analysis. The results were presented using text, tables and figure. ResultSeven hundred eighty four patients were included in this study. Of all study participants, 508 (64.8%) were females. More than half participants 376 (47.96%) were in the age range of (31–45) years. The overall prevalence of treatment failure was 27.48%; of this 12.35% of the participants developed immunologic failure and 4.70% of them had both immunologic and virologic failure. Factors that were significantly associated with treatment failure following multivariable analysis were rural resident [AOR = 3.6; 95% CI (1.11–7.36)], WHO stage III/IV [AOR = 2.7; 95% CI (1.21–5.08)], baseline CD4 count (cells/mm3) less than 199 [AOR = 8.11; 95% CI (2.46–19.54)], treatment interruption [AOR = 5.4; 95% CI (2.61–10.45)], poor drug adherence [AOR = 5.9; 95% CI (1.15–12.43)] and TB/HIV co-infection [AOR = 4.6; 95% CI (1.33–12.12). ConclusionThe prevalence of ART failure was higher. Multivariate analysis showed that rural residency, WHO clinical stage III/IV, baseline CD4 count (cells/mm3) less than 200, treatment interruption, poor drug adherence, opportunistic infections and TB/HIV co-infection were significantly associated with treatment failure.