HIV/AIDS: Research and Palliative Care (Nov 2020)
Determinants of Virologic Failure Among Adults on Second Line Antiretroviral Therapy in Wollo, Amhara Regional State, Northeast Ethiopia
Abstract
Ali Seid,1 Niguss Cherie,2 Kemal Ahmed3 1Reproductive and Family Health Unit, Dessie Health Science College, Dessie, Ethiopia; 2Reproductive and Family Health Unit, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 3School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Niguss CherieReproductive and Family Health Unit, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, EthiopiaTel +251 910749743Email [email protected]: Treatment failure among the population on second line antiretroviral therapy is a major public health threat. In Ethiopia there has been limited research done on second line treatment failure.Objective: To identify determinants of virologic failure among adults on second line antiretroviral therapy in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia.Methods: An institution-based unmatched case–control study was conducted from February 1, 2020 to April 30, 2020 on a total of 377 clients in six public hospitals of Wollo, Amhara regional state, northeast Ethiopia. Clients whose viral load result > 1,000 copies/mL in two consecutive results at least 3 month apart were cases, while ≤ 1,000 copies/mL were controls. The sample size was calculated by using Epi-Info version 7. Cases (94) and controls (283) were selected using a simple random sampling method in a ratio of cases-to-controls of 1:3. The model fitted and binary logistic assumptions were fulfilled with 95% confidence level and P-values< 0.05 were taken as statistically significant.Results: Virologic failure was predicted by poor adherence (AOR=6.060, 95% CI=2.837– 12.944), not disclosing their HIV status (AOR=4.178, 95% CI=1.431– 12.198), OI (AOR=4.11, 95% CI=1.827– 9.246), CD4 count < 100 cells/mm3 (AOR=3.497, 95% CI=1.233– 9.923) and 100– 350 cells/mm3 (AOR=5.442, 95% CI=2.191– 13.513), low BMI < 16 kg/m2 (AOR=7.223, 95% CI=2.218– 23.520), and young age 15– 29 years (AOR=2.898, 95% CI=1.171– 7.170).Conclusion and Recommendations: Determinants of second line ART virologic failure were patients who had poor adherence to ART, not disclosed, opportunistic infection, low CD4 counts < 350 cell/mm3, low BMI (< 16 kg/m2), and young age 15– 29 year patients. Social support, disclosing their HIV status, and getting early treatment for any opportunistic infection is crucial to patients.Keywords: HIV, second line ART, virologic failure, case–control study, Wollo, northeast Ethiopia
