HIV/AIDS: Research and Palliative Care (Aug 2023)
The Influence of Age-Associated Comorbidities on Responses to Combination Antiretroviral Therapy Among People Living with HIV, at the ART Clinic of Jimma Medical Center, Ethiopia: A Hospital-Based Nested Case-Control Study
Abstract
Abebaw Abie,1 Mekonnen Damessa2 1Department of Pharmacy, College of Medicine and Health Science, Debre-Markos University, Debre-Markos, Ethiopia; 2Department of Pharmacy, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Mekonnen Damessa, P.O.box: 378, Tel +251924100153, Email [email protected]: Despite the high prevalence of age-associated comorbidities in HIV patients in sub-Saharan Africa, there is a lack of data on their influence on treatment outcomes in HIV patients. Therefore, this study aimed to assess the impact of age-associated comorbidities on responses to antiretroviral therapy (ART) among people living with HIV.Methods: A hospital-based nested case–control study was conducted among adult HIV-infected patients at the Jimma Medical Center from January 3 to June 2, 2022. Data were recorded by interviewing the patients and their medical chart and analyzed using The Statistical Package for Social Science (SPSS) v. 23, and at p < 0.05.The Results: The overall immunological and virologic failure rates were 13.8% and 13.4%, respectively. Being male [AOR = 3.079,95% CI (1.139– 8.327)], having age-associated comorbidity [AOR:10.57,95% CI (2.810– 39.779)], age ≥ 50 years [AOR = 2.855, 95% CI (1.023– 7.9650)], alcohol intake [AOR = 3.648,95% CI (1.118– 11.897)], and having a baseline CD4+ count of < 200 cells/uL [AOR:3.862, 95% CI (1.109– 13.456) were an independent predictor of immunological failure; Whereas Being alcoholic [AOR:3.11, 95% CI (1.044– 9.271)], having a baseline CD4+ count of < 200 cells/uL [AOR:5.11, 95% CI (1.547– 16.892)], a low medication adherence [AOR:5.92, 95% CI (1.81– 19.36)], bedridden baseline functional status [AOR:3.902, 95% CI (1.237– 12.307)], and lack of cotrimoxazole prophylaxis [AOR:2.735,95% CI (1.084– 6.902)] were found to be an independent predictor of virologic treatment failure, but being younger (age < 50 years) was protective for virologic failure.Conclusion: Out of the eight patients who were treated for HIV at least one patient had developed immunological and/or virological failure. Age-associated comorbid chronic non-communicable diseases highly influence immunological outcomes compared with virological outcomes. Health providers should pay attention to age-associated comorbidities, encourage lifestyle modifications, and counsel on medication adherence to improve clinical outcomes in patients with HIV.Keywords: age-associated comorbidity, combination antiretroviral therapy, HIV, immunological failure, virological failure, sub-Saharan Africa
