Magnitude and Associated Factors of Virological Failure Among Children on ART in Bahir Dar Town Public Health Facilities, Northwest Ethiopia: a Facility Based Cross-sectional Study

Walle, Belete Gelaw; Mulatu, Getasew; Tesfa, Getasew; Marew, Chalie; Chekole, Bogale; Alebel, Animut

doi:10.21203/rs.3.rs-151768/v1

Cited by 1 publication

(4 citation statements)

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“…Other predictors of virological failure in this study were recent opportunistic infection, those children and adolescents with recent opportunistic infection were 4.6 times more hazard of failure than those who had no recent opportunistic infection. This is consistent with a study conducted Bihar Dar [ 37 ]. This can be explained by children and adolescents with recent infection increasing the risk of concomitant opportunistic infection which in turn lowers their immunity and decrease their adherence to medication which further complicates the outcome [ 37 ].…”

Section: Discussionsupporting

confidence: 93%

“…This is consistent with a study conducted Bihar Dar [ 37 ]. This can be explained by children and adolescents with recent infection increasing the risk of concomitant opportunistic infection which in turn lowers their immunity and decrease their adherence to medication which further complicates the outcome [ 37 ]. In addition, those children and adolescents with recent opportunistic infections may have a severe disease like TB, which will increase drug burden and side effects, and decrease drug efficiency.…”

Section: Discussionsupporting

confidence: 93%

“…The overall incidence rate of virological failure in this study was 4.2 (95% CI: 3.41, 5.22) per 1000 person-months of observation. The result is in line with a study conducted in southern Ethiopia, Tigray region and Bahir Dar, with an incidence rate of 4.97 [21], 5.1 [34,37] respectively. This similarity could be due to a similar period of study and cut-off point that had been used to define virological failure.…”

Section: Discussionsupporting

confidence: 91%

“…However, the success of ART depends on adherence to the treatment regimen [ 1 ]. Poor adherence decreases drug effectiveness, which declines immunity this will in turn increase the risk of opportunistic infection and drug resistance [ 37 ]. This in turn increases rates of viral replication, high rates of CD4 destruction, accumulations of resistant viruses, and faster rates of disease progression.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and predictors of virological failure among HIV infected children and adolescents on first-line antiretroviral therapy in East Shewa hospitals, Oromia Region, Ethiopia: A retrospective follow up study

Abera,

Alemu,

Agegnehu

2023

PLoS ONE

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Introduction Despite gains made from improved antiretroviral therapy coverage in resource limited countries, the occurrence of first line drug resistance remains a priority agenda. To reduce the emergence of resistant viruses, HIV viral load monitoring plays a critical role. However, many resource limited countries have difficulty of monitoring viral load due to economic constraints.There is also limited study regarding viral failure in developing countries. Therefore, this study aimed to assess the incidence and predictors of virological failure among HIV-infected children and adolescents on first-line ART Ethiopia, 2021. Methods Institution based retrospective follow-up study was employed on 492 children and adolescents. Data were collected by trained nurses who have experience working in ART clinics. Data were entered using Epi-data version 4.6 and exported to Stata version 14 for analysis. The proportional hazard assumption was checked, and the Weibull regression was fitted. Cox-Snell residual was used to test the goodness of fit, and the appropriate model was selected by AIC. Finally, an AHR with a 95% CI was computed, and variables with a P-value < 0.05 in the multivariable analysis were taken as significant predictors of virological failure. Results The overall incidence rate of virological failure was 4.2, (95% CI: 3.41, 5.22) per 1000 person-months of observation with 20,169 person-months follow-up time. In multivariable analysis living in rural area (AHR = 1.97, 95% CI: 1.15–3.36), poor adherence (AHR = 2.20, 95% CI: 1.24–3.91), lower CD4 Count <200 cells/mm3 (AHR = 2.57, 95% CI: 1.27–5.18) and 201–350 cells/mm3 (AHR = 2.44, 95% CI: 1.28–4.67) respectively, and recent OI (AHR = 4.60, 95% CI: 2.38–8.90) are significantly associated with virological failure. Conclusion The incidence rate of virological failure was high. Living in a rural, poor adherence, lower CD4 count, and recent opportunistic infection were independent risk factors associated with virological failure. Hence, it is better to give priority to strengthening the focused evaluation of important variables and managing accordingly.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%