Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia

Helen Assefa Mekonnen; Fantu Mamo Aregaw; Tesfaye Yesuf; Nebiyu Mekonnen Derseh

doi:doi:10.11648/j.ijidt.20230802.14

| Peer-Reviewed

Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia

Helen Assefa Mekonnen, Fantu Mamo Aregaw, Tesfaye Yesuf, Nebiyu Mekonnen Derseh

Published in International Journal of Infectious Diseases and Therapy (Volume 8, Issue 2)

Received: 14 February 2023 Accepted: 22 May 2023 Published: 31 May 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Introduction: Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. Objective: This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. Results: The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). Conclusion and recommendation: The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.

Published in	International Journal of Infectious Diseases and Therapy (Volume 8, Issue 2)
DOI	10.11648/j.ijidt.20230802.14
Page(s)	69-79
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Prevalence, First-Line Antiretroviral Therapy, Virological Failure, Adults, Northwest Ethiopia

References

[1]	WHO. https://www.who.int/news-room/questions-and answers/item/HIV-AIDS: Q&A 30 November 2020
[2]	Ayele G, Tessema B, Amsalu A, Ferede G, Yismaw G. Prevalence and associated factors of treatment failure among HIV/AIDS patients on HAART attending University of Gondar Referral Hospital Northwest Ethiopia. BMC Immunology. 2018; 19 (1): 37. doi: 10.1186/s12865-018-02784.
[3]	Ethiopian Federal Minestry of Health. National consolidated guidelines for comprehensive HIV prevention, care and treatment. guidline. Addis Ababa: EFMOH; 2018.
[4]	Gregson J, Tang M, Ndembi N, Hamers RL, Rhee S-Y, Marconi VC, et al. Global epidemiology of drug resistance after failure of WHO recommended first-line regimens for adult HIV-1 infection: a multicentre retrospective cohort study. The Lancet Infectious Diseases. 2016; 16 (5): 565-75. doi: 10.1016/s1473-3099(15)00536-8.
[5]	World Health Organization. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach, 2nd edition. Geneva, Switzerland: World Health Organization; 2016.
[6]	World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. Geneva: WHO; 2021.
[7]	Lecher SL, Naluguza M, Mwangi C, al. e. Notes from the Field: Impact of the COVID-19 Response on Scale-Up of HIV Viral Load Testing — PEPFAR-Supported Countries, January–June 2020. MMWR Morb Mortal Wkly 2021; 70: 94–795. doi: http://dx.doi.org/10.15585/mmwr.mm7021a3.
[8]	Tamrat Endebu *, Alem Deksisa, Tibka Moges, Teresa Kisi, Temesgen Ensermu. Incidence of Virological Failure and Associated Factors among Adult HIV-Positive Patients on First Line Antiretroviral Therapy Regimen, Central Ethiopia. International Journal of HIV/AIDS Prevention, Education and Behavioural Science 2018; 4 (2): 4451. doi: 11648/j.ijhpebs.20180402.13.
[9]	UNAIDS. Global HIV & AIDS statistics: Fact sheet. 2021.
[10]	WHO. HIV drug resistance report 2021. Geneva: World Health Organization; 2021.
[11]	UNAIDS. Global AIDS update 2021. 2021.
[12]	Dorward J, Lessells R, Drain PK, Naidoo K, de Oliveira T, Pillay Y, et al. Dolutegravir for first-line antiretroviral therapy in low-income and middle-income countries: uncertainties and opportunities for implementation and research. 2018; 5 (7): e400-e4.
[13]	Gupta RK, Gregson J, Parkin N, Haile-Selassie H, Tanuri A, Forero LA, et al. HIV-1 drug resistance before initiation or re-initiation of first-line antiretroviral therapy in low-income and middle-income countries: a systematic review and meta-regression analysis. J The Lancet infectious diseases. 2018; 18 (3): 346-55.
[14]	Wallis CL, Godfrey C, Fitzgibbon JE, Mellors JWJTJoid. Key factors influencing the emergence of human immunodeficiency virus drug resistance in low-and middle-income countries. 2017; 216 (suppl_9): S851-S6.
[15]	Nachega JB, Sam-Agudu NA, Mofenson LM, Schechter M, Mellors JW. Achieving viral suppression in 90% of people living with human immunodeficiency virus on antiretroviral therapy in low-and middle-income countries: progress, challenges, and opportunities. J Clinical Infectious Diseases. 2018; 66 (10): 1487-91.
[16]	UNAIDS. joint United Nations Program on HIV/AIDS. Geneva Switzerland: 2021 Contract No.: Licence: CC BY-NC-SA 3.0 IGO.
[17]	Hauser A, Goldstein F, Reichmuth ML, Kouyos RD, Wandeler G, Egger M, et al. Acquired HIV drug resistance mutations on first-line antiretroviral therapy in Southern Africa: Systematic review and Bayesian evidence synthesis. Journal of clinical epidemiology. 2022; 148: 135-45. Epub 2022/02/23. doi: 10.1016/j.jclinepi.2022.02.005. PubMed PMID: 35192922; PubMed Central PMCID: PMCPMC9388696.
[18]	PEPFAR-Ethiopia. Ethiopia Country Operational Plan COP 2021 Strategic Direction Summary Final May 26, 2021. 2021.
[19]	Marconi VC, Wu B, Hampton J, Ordóñez CE, Johnson BA, Singh D, et al. Early Warning Indicators for First-Line Virologic Failure Independent of Adherence Measures in a South African Urban Clinic. AIDS Patient Care and STDs. 2013; 27 (12): 657-68. doi: 10.1089/apc.2013.0263.
[20]	Bereda G. Rationale of Antiretroviral Treatment Failure-Hence Forth Implication of Clinical Management and Hospital Practice, 2021. J J Clin Med Img. 2021; 5 (16): 1-8.
[21]	Kyaw NT, Harries AD, Kumar AM, Oo MM, Kyaw KW, Win T, et al. High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015. PloS one. 2017; 12 (2): e0171780. doi: 10.1371/journal.pone.0171780. PubMed PMID: 28182786; PubMed Central PMCID: PMC5300167.
[22]	Emagnu A, Abay Z, Bulti AB, Animut Y. Determinants of Virologic Failure among Adult HIV Patients on First-Line Antiretroviral Therapy at Waghimra Zone, Northern Ethiopia: A Case-Control Study. Advances in Public Health. 2020; 2020: 1-8. doi: 10.1155/2020/1929436.
[23]	Shanmukhappa SC, Abraham RR, Huilgol P, Godbole R, Anand AK, Prasad R, et al. What influences adherence among HIV patients presenting with first-line antiretroviral therapy failure (ART failure)? A retrospective, cross-sectional study from a private clinic in Nagpur, India. Journal of family medicine and primary care. 2020; 9 (12): 6217-23. doi: 10.4103/jfmpc.jfmpc_1155_20. PubMed PMID: 33681067; PubMed Central PMCID: PMC7928081.
[24]	Mulisa D, Tolossa T, Wakuma B, Etafa W, Yadesa G. Magnitude of first line antiretroviral therapy treatment failure and associated factors among adult patients on ART in South West Shoa, Central Ethiopia. PloS one. 2020; 15. doi: 10.1371/journal.pone.0241768.
[25]	Genet A, Mekonnen Z, Yizengaw E, Mekonnen D. First line antiretroviral treatment failure and associated factors among people living with HIV in northwest Ethiopia. African Health Sciences. 2021; 21 (1): 263-72.
[26]	Getaneh Y, Egziabhier AG, Zealiyas K, Tilahun R, Girma M, Deressa T, et al. HIV-1 treatment failure among population taking antiretroviral therapy in Ethiopia. 2019; 1 (2): 46-57.
[27]	Teklehaimanot Fentie Wendie, Birhanu Demeke Workneh. Prevalence-and predictors-of-virological-failure among-adult living with HIV in south wollo, northeast Ethiopia, retrosective cohort study. HIV AIDS - Research and palliative care. 2020; 12: 393-402. doi: 10.2147/HIV.S266460.
[28]	Nega J, Taye S, Million Y, Rodrigo C, Eshetie S. Antiretroviral treatment failure and associated factors among HIV patients on first-line antiretroviral treatment in Sekota, northeast Ethiopia. J AIDS Research. 2020; 17 (1): 1-9.
[29]	Aishah Khan, Unnikrishnan, BA, Vaman Kulkarni, Ramesh Holla, John T. Ramapuram a, et al. Long-Term Impact of First-Line Anti-Retroviral Therapy on HiV-1 Positive Patients: A Retrospective Study in Karnataka, India. The Open AIDS Journal. 2022; 16. doi: 10.2174/18746136-v16-e2112200.
[30]	Bereda G, Bereda G. Prevalence of, and Factors Influencing First Line Antiretroviral Treatment Failure among Adult HIV Patients at Antiretroviral Treatment Clinic of Mettu Karl Referral Hospital, South Western, Ethiopia: A Prospective Cross-Sectional Study, 2021. J Int J Virol AIDS. 2021; 8: 075.
[31]	Assemie MA, Alene M, Ketema DB, Mulatu S, policy. Treatment failure and associated factors among first line patients on highly active antiretroviral therapy in Ethiopia: a systematic review and meta-analysis. Global health research. 2019; 4 (1): 1-10.
[32]	Demsie DG, Bantie AT, Allene MD, Alema NM, Gebrie D. Antiretroviral treatment failure among HIV-positive adults taking first-line therapy and associated risk factors at Adigrat General hospital, Adigart, Ethiopia 2019: A cross sectional study. International Journal of Surgery Open. 2020; 26: 16-21.
[33]	Kiweewa F, Esber A, Musingye E, Reed D, Crowell TA, Cham F, et al. HIV virologic failure and its predictors among HIV-infected adults on antiretroviral therapy in the African Cohort Study. J PLoS One. 2019; 14 (2): e0211344.
[34]	Nasomsong W, Phokaphol K, Changpradub D. First-Line Antiretroviral Regimen Failure and Determinants in an Urban HIV Clinic at Phramongkutklao Hospital, Bangkok, Thailand: 20 Years Experience. HIV AIDS (Auckl). 2021; 13: 261-9. Epub 20210304. doi: 10.2147/HIV.S295512. PubMed PMID: 33692637; PubMed Central PMCID: PMCPMC7939509.
[35]	Fentaw Z, Molla A, Wedajo S, Mebratu W. Determinants of Virological Failure Among Adult Clients on First-Line Antiretroviral Therapy in Amhara Regional State, Northeast Ethiopia. A Case -Control Study. HIV AIDS (Auckl). 2020; 12: 749-56. Epub 2020/11/27. doi: 10.2147/hiv. S267629. PubMed PMID: 33239920; PubMed Central PMCID: PMCPMC7680783.
[36]	Abdullahi IJ, Deybasso HA, Adlo AM. Determinants of virological failure among patients on first-line antiretroviral therapy in central Oromia, Ethiopia: a case–control study. HIV/AIDS. 2020; 12: 931.
[37]	Mulisa D, Tesfa M, Mullu Kassa G, Tolossa T. Determinants of first line antiretroviral therapy treatment failure among adult patients on ART at central Ethiopia: un-matched case control study. BMC Infectious Diseases 2012. 2019; 19 (1): 1-13.
[38]	Agegnehu CD, Merid MW, Yenit MK. Incidence and predictors of virological failure among adult HIV patients on first-line antiretroviral therapy in Amhara regional referral hospitals; Ethiopia: a retrospective follow-up study. BMC Infectious Diseases 2012. 2020; 20 (1): 1-14.
[39]	Bezabih YM, Beyene F, Bezabhe WM. Factors associated with first-line antiretroviral treatment failure in adult HIV-positive patients: a case-control study from Ethiopia. BMC Infectious Diseases 2012. 2019; 19 (1): 1-8.

Cite This Article

Plain Text BibTeX RIS

APA Style

Helen Assefa Mekonnen, Fantu Mamo Aregaw, Tesfaye Yesuf, Nebiyu Mekonnen Derseh. (2023). Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. International Journal of Infectious Diseases and Therapy, 8(2), 69-79. https://doi.org/10.11648/j.ijidt.20230802.14

Copy | Download

ACS Style

Helen Assefa Mekonnen; Fantu Mamo Aregaw; Tesfaye Yesuf; Nebiyu Mekonnen Derseh. Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Int. J. Infect. Dis. Ther. 2023, 8(2), 69-79. doi: 10.11648/j.ijidt.20230802.14

Copy | Download

AMA Style

Helen Assefa Mekonnen, Fantu Mamo Aregaw, Tesfaye Yesuf, Nebiyu Mekonnen Derseh. Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Int J Infect Dis Ther. 2023;8(2):69-79. doi: 10.11648/j.ijidt.20230802.14

Copy | Download

@article{10.11648/j.ijidt.20230802.14,
  author = {Helen Assefa Mekonnen and Fantu Mamo Aregaw and Tesfaye Yesuf and Nebiyu Mekonnen Derseh},
  title = {Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {8},
  number = {2},
  pages = {69-79},
  doi = {10.11648/j.ijidt.20230802.14},
  url = {https://doi.org/10.11648/j.ijidt.20230802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20230802.14},
  abstract = {Introduction: Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. Objective: This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. Results: The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). Conclusion and recommendation: The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia
AU  - Helen Assefa Mekonnen
AU  - Fantu Mamo Aregaw
AU  - Tesfaye Yesuf
AU  - Nebiyu Mekonnen Derseh
Y1  - 2023/05/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ijidt.20230802.14
DO  - 10.11648/j.ijidt.20230802.14
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 69
EP  - 79
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20230802.14
AB  - Introduction: Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. Objective: This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. Results: The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). Conclusion and recommendation: The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.
VL  - 8
IS  - 2
ER  -

Copy | Download

Author Information

Helen Assefa Mekonnen

Debre Tabor Comprehensive Specialized Hospital, Amhara Health Bureau, Debre Tabor, Ethiopia
Fantu Mamo Aregaw

Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Tesfaye Yesuf

School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Nebiyu Mekonnen Derseh

Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Helen Assefa Mekonnen, Fantu Mamo Aregaw, Tesfaye Yesuf, Nebiyu Mekonnen Derseh. (2023). Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. International Journal of Infectious Diseases and Therapy, 8(2), 69-79. https://doi.org/10.11648/j.ijidt.20230802.14

Copy | Download

ACS Style

Helen Assefa Mekonnen; Fantu Mamo Aregaw; Tesfaye Yesuf; Nebiyu Mekonnen Derseh. Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Int. J. Infect. Dis. Ther. 2023, 8(2), 69-79. doi: 10.11648/j.ijidt.20230802.14

Copy | Download

AMA Style

Helen Assefa Mekonnen, Fantu Mamo Aregaw, Tesfaye Yesuf, Nebiyu Mekonnen Derseh. Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Int J Infect Dis Ther. 2023;8(2):69-79. doi: 10.11648/j.ijidt.20230802.14

Copy | Download

@article{10.11648/j.ijidt.20230802.14,
  author = {Helen Assefa Mekonnen and Fantu Mamo Aregaw and Tesfaye Yesuf and Nebiyu Mekonnen Derseh},
  title = {Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {8},
  number = {2},
  pages = {69-79},
  doi = {10.11648/j.ijidt.20230802.14},
  url = {https://doi.org/10.11648/j.ijidt.20230802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20230802.14},
  abstract = {Introduction: Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. Objective: This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. Results: The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). Conclusion and recommendation: The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Prevalence of Virologic Failure and Determinants Among Adults on First-Line Antiretroviral Therapy at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia
AU  - Helen Assefa Mekonnen
AU  - Fantu Mamo Aregaw
AU  - Tesfaye Yesuf
AU  - Nebiyu Mekonnen Derseh
Y1  - 2023/05/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ijidt.20230802.14
DO  - 10.11648/j.ijidt.20230802.14
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 69
EP  - 79
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20230802.14
AB  - Introduction: Even though first-line antiretroviral therapy (ART) has led to a profound reduction in the incidence of opportunistic infections (OIs) and AIDS related deaths, it is challenged by virologic failure, which predisposes patients to a new or recurrent clinical condition and, as a result, affects their quality of life and increases HIV-associated mortality. Therefore, understanding the burden of virologic failure and its determinants helps with early prevention and improvement of the quality of life. However, the prevalence of virologic failure and its associated factors among adult patients on first-line ART at Debre Tabor Comprehensive Specialized Hospital is not well understood. Objective: This study was aimed at determining the prevalence of virologic failure and identifying its contributing factors among HIV-positive adults receiving first-line ART at Debre Tabor Comprehensive Specialized Hospital in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted on 376 adults who had started ART from February 8, 2017, to February 7, 2022. After selecting a computer-generated simple random sampling technique, data on patients' socio-demographic, behavioral, clinical, and ART-related factors were collected through a review of medical charts. A binary logistic regression model was used to identify associated factors with virologic failure, and an AOR with a 95% CI at P less than or equal to 0.05 was used to declare the association. Results: The prevalence of virologic failure was 13.6% (95% CI: 10.4%- 17.2%). Significant associated factors for virological failure were smoking cigarettes (AOR 4.76, 95% CI: 1.06-21.38), HIV non-disclosure (AOR 4.56, 95% CI: 1.6- 2.46), presence of stigma and discrimination (AOR 2.91, 95% CI: 1.14-7.39), having baseline OIs (AOR 6.66, 95% CI: 1.94-22.90), not taking CPT (AOR 3.21, 95% CI: 1.12-9.18), treatment interruption (AOR 2.97, 95% CI: 1.11-7.94), loss to follow-up (AOR 9.03, 95% CI: 3.08-26.47), fair or poor adherence status for ART (AOR 3.409, 95% CI: 1.26-9.24). Conclusion and recommendation: The prevalence of virologic failure was in line with the national prevalence. Smoking cigarettes, HIV non-disclosure, baseline OIs, suboptimal adherence, loss to follow-up, treatment interruption, not taking CPT, and taking additional medication were significantly associated with virological failure. Therefore, special attention should be given to those individuals who have the above factors to minimize and prevent virologic failure.
VL  - 8
IS  - 2
ER  -

Copy | Download