Assessment of Factors for Hiv Virologic Treatment Failure among Adult Patients on First-Line Art at Public Hospitals in Addis Ababa, Ethiopia
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Date
2022-10-17
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Addis Ababa University
Abstract
Background: Currently treatment for HIV is sought to improve quality of life in HIV infected people by decreasing opportunistic infections, reducing disease progression to AIDS, and preventable deaths. Thus, knowing factors for virologic treatment failure is of a key importance in the treatment of HIV.
Objective: To assess factors for HIV virologic treatment failure among adult patients on first-line ART at public hospitals in Addis Ababa, Ethiopia 2022.
Methods :A case-control study using quantitative method was conducted at randomly selected public Hospitals in Addis Ababa. A total of 284 medical records of patients on first line ART were randomly selected with a case to control ratio of 1:2; 95 cases with HIV virologic treatment failure and 189 controls with no virologic treatment failure. Data on socio-demographic clinical and adherence related variables were collected using data extraction questionnaire. Variables with p value <0.2 on bivariable logistic regression were entered to multivariable analysis. Backward likelihood logistic regression analysis was performed using SPSS (Statistical Package for Social science) -version 25 to identify independent factors for virologic treatment failure. P-value less than or equal to .05 was considered statistically significant.
Results ;A total of 284 medical records were reviewed. Patients on first line ART in age group 18-24 had four times higher [AOR 4.526, 95%CI (1.253,16.351)] and those in the age group 25-34 had two times higher [AOR 2.836, 95% CI (1.103,7.295)] odds in cases than controls. Patients taking ART for a longer duration [AOR 2.349 CI (1.301, 4.242)] and discontinued ART [AOR 2.283CI (1.025-5.084)] were found to have two times higher odds in cases. Patients with ART adherence of fair status [AOR3.193CI (1.602-status [AOR3.101CI (1.214-7.923)] and tuberculosis coinfection [AOR 3.193, 95% CI (1.328,7.678)] were having three times higher odds among cases than controls. Being female [AOR .323 95%CI (.174-.600)] was found inversely associated with virologic treatment failure.6.363)], poor status [AOR3.101CI (1.214-7.923)] and tuberculosis coinfection
[AOR 3.193, 95% CI (1.328,7.678)] were having three times higher odds among cases than controls. Being female [AOR .323 95%CI (.174-.600)] was found inversely associated with virologic treatment failure.
Conclusion: This study showed the age group 18-34, adherence to ART medication of fair and poor status, discontinuing ART treatment for >1 month duration and taking ART for a duration longer than 5 years and TB coinfection within the past year were independent factors directly associated with virologic treatment failure while being female was found to be inversely associated.