Abstract
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.
Highlights
Since the start of the human immunodeficiency virus (HIV) epidemic, 74.9 million people have been infected, and 32 million people have died from acquired immunodeficiency syndrome- (AIDS-) related illnesses
A viral load (VL) assessment that was conducted in 2018 in the Amhara region by the regional health bureau revealed that 18% of people living with the human immunodeficiency virus (PLHIV) on first-line antiretroviral therapy (ART) in Waghimra Zone had a virologic failure [21], which is the highest in the region. erefore, this study aimed to determine factors related to virologic failure among adult PLHIV in the Waghimra zone
All HIV-infected adults whose plasma VL is ≥ 1,000 copies/mL in two consecutive VL measurements within a 3-month interval with adherence support between measurements were defined as cases, while study participants with a VL level of
Summary
Since the start of the human immunodeficiency virus (HIV) epidemic, 74.9 million people have been infected, and 32 million people have died from acquired immunodeficiency syndrome- (AIDS-) related illnesses. In 2018, 37.9 million people were living with HIV/AIDS globally, from which 95% were adults. Of all people living with the human immunodeficiency virus (PLHIV), 62% were accessing treatment and 53% were virally suppressed in 2018 [1]. E World Health Organization (WHO) recommends the use of routine HIV viral load (VL) testing as the preferred approach for PLHIV on ART to monitor treatment response and diagnose treatment failure. A VL assessment that was conducted in 2018 in the Amhara region by the regional health bureau revealed that 18% of PLHIV on first-line ART in Waghimra Zone had a virologic failure [21], which is the highest in the region. Erefore, this study aimed to determine factors related to virologic failure among adult PLHIV in the Waghimra zone A VL assessment that was conducted in 2018 in the Amhara region by the regional health bureau revealed that 18% of PLHIV on first-line ART in Waghimra Zone had a virologic failure [21], which is the highest in the region. erefore, this study aimed to determine factors related to virologic failure among adult PLHIV in the Waghimra zone
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