HIV/AIDS: Research and Palliative Care (Sep 2016)
First-line antiretroviral treatment failure and associated factors in HIV patients at University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia
Abstract
Mohammed Biset Ayalew,1 Dawit Kumilachew,2 Assefa Belay,3 Samson Getu,4 Derso Teju,4 Desalegn Endale,4 Yemisirach Tsegaye,4 Zebiba Wale4 1Department of Clinical Pharmacy, 2Department of Pharmaceutics, 3Department of Pharmacology, 4School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Antiretroviral therapy (ART) restores immune function and reduces HIV-related adverse outcomes. But treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. The aim of this study was to determine the prevalence and factors associated with first-line ART failure in HIV patients at the University of Gondar Teaching Hospital.Patients and methods: A retrospective study was conducted on 340 adults who had started ART during the period of September 2011 to May 2015. Data regarding patients’ sociodemographics, baseline characteristics, and treatment-related information were collected through review of their medical charts. Data were analyzed using SPSS version 21. Descriptive statistics, cross-tabs, and binary and multiple logistic regressions were utilized. P<0.05 was used to declare association.Results: Among the 340 patients enrolled, 205 were females (60.3%). The mean age at ART initiation was 34.4 years. A total of 14 (4.1%) patients were found to have treatment failure. The median duration of treatment failure from initiation of treatment was 17.5 months (8–36 months). Poor adherence to treatment and low baseline CD4 cell count were found to be significant predictors of treatment failure.Conclusion: The prevalence of first-line ART failure was 4.1%. Treatment failure was most likely to occur for the patients who had poor drug adherence and those who were delayed to start ART till their CD4 cell count became very low (<100 cells/mm3). Keywords: treatment failure, antiretroviral drugs, risk factor, adherence