Abstract
BackgroundVirological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors. However, there were few studies done on the predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Ethiopia in general, and no study was done in the study area in particular. Therefore, the aim of the study was to identify predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Woldiya and Dessie Hospitals, Northeast Ethiopia.MethodHospital based case–control study was conducted in Woldia and Dessie Hospitals from from 12 August 2016–28 February 2018 on 154 cases and 154 controls among adult patients on first-line antiretroviral treatment. All cases were included and comparable controls were selected using stratified random sampling technique. Data were collected by document review using checklists and entered into Epidata version 3.1 and analyzed by SPSS version 21.Multivariable logistic regression analysis was done to identify the independent predictors of virological treatment failure.ResultsIn this study, statistically higher odds of virological failure was observed among patients who had current CD4 T-cell count of < 200 mm3 (AOR = 2.4, 95% CI: 1.35, 4, 18) compared withCD4 T-cell count of > 200 mm3, current body mass index(BMI) < 16 kg/m2 (AOR = 4.2, 95% CI:1.85, 9.51) compared with BMI > 18.5 kg/m2, BMI between 16 and 18.5 kg/m2 (AOR = 3.72, 95% CI: 1.75, 7.92) versus BMI > 18.5 kg/m2, poor adherence to antiretroviral therapy (AOR = 5.4, 95% CI: 2.95, 9.97) compared with good adherence.ConclusionThis study showed that low current CD4 T-cell count and body mass index, as well as poor adherence for ART treatment predicts virological failure. Therefore, deliberate efforts are urgently needed in HIV care through improving their nutritional status by enhancing nutritional education and support, and by strengthening enhanced adherence counseling.
Highlights
Virological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors
In this study, statistically higher odds of virological failure was observed among patients who had current Cluster Designated 4 (CD4) T-cell count of < 200 mm3 (AOR = 2.4, 95% Confidence interval (CI): 1.35, 4, 18) compared withCD4 T-cell count of > 200 mm3, current body mass index(BMI) < 16 kg/m2 (AOR = 4.2, 95% CI:1.85, 9.51) compared with BMI > 18.5 kg/m2, BMI between 16 and 18.5 kg/m2 (AOR = 3.72, 95% CI: 1.75, 7.92) versus BMI > 18.5 kg/m2, poor adherence to antiretroviral therapy (AOR = 5.4, 95% CI: 2.95, 9.97) compared with good adherence
This study showed that low current CD4 T-cell count and body mass index, as well as poor adherence for antiretroviral treatment (ART) treatment predicts virological failure
Summary
Virological treatment failure is a problem that a Human Immune Virus patient faces after starting treatment due to different factors. There were few studies done on the predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Ethiopia in general, and no study was done in the study area in particular. The aim of the study was to identify predictors of virological treatment failure among adult patients on first-line antiretroviral therapy in Woldiya and Dessie Hospitals, Northeast Ethiopia. The global scale-up of antiretroviral treatment (ART) under the public health approach of standardized and simplified regimens has registered significant gains, with increasing access to treatment for millions of people, and a reduction in new infections and Human Immune Virus(HIV)-associated morbidity and mortality [1]. Different studies showed that virological failure is a problem that an HIV patient faces after starting treatment and the magnitude of the problem is apparent in different countries:20.8% in China [7], 16% in Swaziland [8], 24.6% in Kenya [9], 24% in Mozambique [10], 41.3% in Gabon [11], 11.9% in Rwanda [12], 11% in Uganda [13], and 10.7% in Bahirdar, Ethiopia [14]
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