The use of third-line combined antiretroviral treatment and determinants of treatment outcomes among HIV/AIDS patients in Ethiopia
| dc.contributor.advisor | Amogne,Wondwossen(MD, PhD) | |
| dc.contributor.author | Eshetu,Anteneh | |
| dc.date.accessioned | 2025-08-13T07:55:38Z | |
| dc.date.available | 2025-08-13T07:55:38Z | |
| dc.date.issued | 2023-11 | |
| dc.description.abstract | Background: The treatment of human immunodeficiency virus (HIV) infection involves the use of combination antiretroviral therapy (cART). The use of these multidrug regimens substantially reduces the progression to AIDS, opportunistic infections, hospitalizations, and death. The standard of care in HIV management is to maximally suppress plasma HIV RNA to prevent HIV disease progression and the emergence of drug-resistant virus. Third-line regimens include drugs such as newer generation NNRTIs like etravirine (ETV), boosted PIs like ritonavir-boosted darunavir (DRV/r), as well as the integrase inhibitor like Dolutegravir (DTG) with or without previously used ARV drugs that potentially maintained residual antiviral activity, especially from the NRTI class.(1,2) Although there were few studies with newer agents, cohort data showed high mortality among people for whom second-line ART had failed. Salvage regimens were recommended with new drugs such as DRV/r, ETV and RAL. Objectives: General objectives: To describe baseline, virologic and therapeutic characteristics of PWHIV on 3rd line cART Specific objectives To analyse the virologic suppression in PWHIV on 3rd line cART To describe the adherence status of PWHIV on 3rd line cART To assess the duration of protease inhibitors’ exposure in PWHIV on 3rd line cART To analyse medical comorbidities in PWHIV on 3rd line cART Methods: This is a retrospective study with longitudinal analysis among adults (≥ 18 years) attending Tikur Anbessa Specialized Hospital, Infectious Diseases unit, ART clinic. Then, a longitudinal analysis was conducted to determine virological suppression among patients who was initiated on third-line therapy and for whom a follow-up viral load was determined. The study is aimed to describe the population of patients on third-line therapy. Results: A total of 51 patients are on third line cART( both guideline and expert recommended regimens). Fifty one percent (n= 26) patients are female. Majority of the respondents claimed that they acquired the virus through unprotected sexual intercourse (66%) and 28% percent of patents acquired the virus through vertical transmission from mother to child. Majority of patients had WHO stage-III or stage-IV defining conditions (37.3% & 35.3% respectively). Tenofovir Disoproxil Fumarate/Lamivudine/Efavirenz was the first line regimen in 37.3% of patients and Tenofovir Disoproxil Fumarate, Lamivudine and Ritonavir boosted Atazanavir was a second line cART in 39.2% patients. Dolutegravir, Lamivudine, Ritonavir boosted Darunavir is the expert recommended third line regimen (94.1%). 76.5% (n= 39) have undetectable viral load on third line cART. Patients transferred due to first line treatment failure had an 11 times greater chance of having undetectable HIV RNA levels compared to those referred due to second line treatment failure. Conclusions: The use of expert recommended third line cART composed of DTG, 3TC, DRV and RTV is effective in our setting especially in PWHIV who are referred to our center after 1st line cART treatment failure. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6691 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | HIV/AIDS | |
| dc.subject | Third line cART | |
| dc.subject | Virologic suppression | |
| dc.title | The use of third-line combined antiretroviral treatment and determinants of treatment outcomes among HIV/AIDS patients in Ethiopia | |
| dc.type | Thesis |