Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia

Abstract

<i>Introduction: </i>Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. <i>Objective: </i>This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. <i>Methods: </i>An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. <i>Results: </i>The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). <i>Conclusion and recommendation: </i>The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.