Treatment Outcomes of HIV-infected Patients on Second Line ART in Selected Health Facilities of Addis Ababa
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Date
2016-01
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Addis Ababa University
Abstract
Background: Ethiopian government launched free ART initiative in 2005, since then, there is
an unprecedented effort to scale-up ART and access to HIV care. Following massive rollout of
ART, large numbers of people are receiving first-line ART and as the cohort mature, the number
of people living with HIV who will fail and switching will steadily increase. Identifying
treatment failure in patients taking ART in order to propose early therapeutic switches to another
available ART regimen is essential. In Ethiopia, there is no study on treatment outcome for the
second line anti-retroviral therapy.
Objective: The aim of this study is to assess the clinical, immunological and virological
treatment outcomes of patients on second line antiretroviral therapy among adult HIV/AIDS
patients in selected public health facilities in Addis Ababa, Ethiopia.
Materials and Methods: A longitudinal study was conducted between July 2014 and June
2015.A total of 236 adult HIV patients who were on second line ART for more than six month
were included. Clinical specimen were collected from each client during routine clinic visits.
Viral load and CD4 cell count tests were done and basic clinical information were extracted
from the medical record. Data analysis was performed using SPSS version 20 software. P values
<0.05 was considered as statistically significant.
Result: Among the total of 236 HIV infected individuals received second line ART,
111(47%)were male and 125(53 %)were female. The mean age was 40+ 10SD (18-78)years and
the average time on second line treatment was 2.4+ 1.17SD(0.5-7.5) years. The average CD4
count at switch to second line ART was 133 cells/mm3(4-519)[95%CI:121.4-145] and there was
significant increase in mean CD4 count to 338 cells/mm3 after switch to second line ART. About
204 (86.4% )the of the patients had undetectable viral load.
Conclusion: In this study, we observed a significant improvement in clinical and immunological
condition as well as good virological suppression in patients after starting second line therapy.
Even though higher viral load suppression observed, 32(13.5% )of the study participants also
have virological failure.
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Keywords
HIV; Health facilities