Prevalence and Factors Associated With Virological Treatment Failure Among Children and Adolescents on Antiretroviral Therapy Attending HIV/AIDS Care and Treatment Clinics in Dodoma Municipality, Central Tanzania

Bitwale, Niyonziza Z; Mnzava, David Paulo; Kimaro, Francisca D; Jacob, Theopista; Mpondo, Bonaventura C. T.; Jumanne, Shakilu

doi:10.1093/jpids/piaa030

Cited by 29 publications

(62 citation statements)

References 38 publications

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“…Our findings revealed that the odds value of virological failure among HIV-infected children with non-disclosure was 4.26 times more compared to those children with disclosed HIV status. This result was consistent with other studies done in Tanzania 17 which revealed that full disclosure of HIV status for children was associated with a protective effect against virological failure and Dodoma municipal 22 which showed that non-disclosed children were 7.74 times more likely to have virological failure than those compared with those disclosed. The result is also in line with the study conducted in Ethiopia 15 , 19 which showed for a checkup that disclosure of HIV status was found to be preventive to virological failure.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, children who had a history of poor adherence were 6.05 times more likely to develop virological 36 which showed that poor adherence increases the odds value of virological failure and Malawi 21 which revealed that a high percentage of virological failure was due to poor adherence. The study was also in line with the study done in Dodoma municipal, 22 Tanzania, 32 and Senegal, 13 Wollo. 37 This might be due to poor adherence causing periodic viral replication that result in the development of drug resistance and limited treatment outcomes.…”

Section: Discussionsupporting

confidence: 85%

“…Of these, all hospitals and 48 health centers provide ART services, and more than 143,225 patients are on ART that account for 69% out of PLHIV in the region. According to the 2013 EFY 8 months report of the Amhara region (22,191,890 total population, above 9,461,290 are children), among 208,001 people living with HIV/AIDS (PLWHA) children account for approximately 13,000, and from 4800 total new infections, 880 are <15 years old children in this region. 33 Finote-Selam General Hospital, four primary hospitals (Adet, Burie, Durbetie, and Merawi) and five health centers (Adet, Burie, Dembecha, Durbetie, and Jiga) were included in the study.…”

Section: Methods and Materials Study Design Setting And Periodmentioning

confidence: 99%

“…11 Studies show that virological failure occurs due to factors, such as being male in gender, [12][13][14][15] age < 3 years, [16][17][18] being orphaned, 14,15 non-disclosure, 15,19 poor adherence, 15,17,20,21 has not being on ART for a long period 13 and take ART suboptimal. 12 In addition, opportunistic infections, [15][16][17]19,20,22,23 malnutrition, 14,16 were WHO stage 3 and 4, 15,24 lower CD4 count (Cells/ mL), 12,15,16,20,[24][25][26] initial viral load >1000 copies/ mL, 21,27 D4T/3TC/NVP based regimen, 21,22,[28][29][30] regimen change, 14,15 longer duration on ART, 15,31 treatment interruption, 12,…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

A¹,

Moges²,

Teshome³

et al. 2021

HIV

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Background Viral load monitoring is a golden indicator for diagnosing treatment failure in patients with HIV. HIV-infected children are considered a priority group for routine viral load monitoring. Globally, the World Health Organization recommends 95% of HIV patients have viral suppression. Factors leading to virological failure are not well understood and studied. This study aimed to determine virological failure among HIV-infected children on first-line antiretroviral therapy in the West Gojjam Zone, Amhara region. Ethiopia. Methods An institutional-based unmatched case–control study was carried out from October 1 to October 15, 2020, among HIV-infected children on first-line antiretroviral therapy. The study included 94 cases and 276 controls, with a total sample size of 370 out of 378 HIV-infected children. A structured English version checklist was used to collect data through chart review. The data were entered using Epi-data 4.2 and exported into SPSS version 20 for analysis. Descriptive statistics were conducted to summarize the sample characteristics. Bivariate and multivariate analyses were used to describe each explanatory variable’s association with the outcome variable. A bivariate analysis with a p-value < 0.25 was selected for multivariate analysis. Adjusted odds ratio with 95% confidence intervals was conducted, and p-value < 0.05 was considered statistically significant. Results Non-disclosure (AOR = 4.26; 95% CI: 2.09, 8.70), baseline viral load >1000 copies/mL (AOR = 10.82; 95% CI: 5.4, 21.67), recent poor adherence (AOR, 6.05, 95% CI, 1.70, 21.55) and missed clinical appointments (AOR = 8.03; 95% CI: 3.88, 16.65) were factors independently associated with virological failure. Conclusion Disclosure of HIV status of patients early, according to their age and adherence to counseling, should be emphasized. Efforts should be strengthened to trace back for missed clinical appointments and strictly follow-up with antiretroviral (ARV) medication for a baseline viral load >1000 copies/mL that helps to boost immunity and suppress viral replication.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

Section: Methods and Materials Study Design Setting And Periodmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

A¹,

Moges²,

Teshome³

et al. 2021

HIV

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show abstract

“…This study is supported by similar finding reported in Tanzania. 36 Disclosure of status is positively associated with better social support, stronger family and relationship cohesion, and reductions in anxiety and depression. This leads to improvements in physical health, emotional support, and financial support which leads to HAART adherence.…”

Section: Discussionmentioning

confidence: 99%

Treatment failure and its associated factors among children receiving highly active antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

et al. 2022

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Objectives: Over the last decades, large number of children living with human immunodeficiency virus (HIV) have been successfully enrolled in care and initiated treatment. However, treatment failure is still a major challenge in the track, missing far too many children. National-level evidence on antiretroviral therapy failure and its associated factors among children receiving highly active antiretroviral therapy is required to alleviate this challenge. Methods: PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, and Google Scholar databases were used to access eligible studies. This meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In addition, Newcastle–Ottawa Scale quality assessment was applied for critical appraisal. Cochran’s Q statistic, funnel asymmetry plot, and Egger’s test were used to assess heterogeneity and publication bias. Random effect model was computed to explore the pooled burden of treatment failure and its associated factors among children living with HIV. Odds ratio with 95% confidence interval was considered to identify associated factors. Result: The overall pooled prevalence of treatment failure among children living with HIV was 16.6%. Whereas virological, immunological, and clinical failure were 4.49%, 5.41%, and 5.71% respectively, where either of parent is deceased (odds ratio = 2.13, 95% confidence interval: 1.4–3.3), opportunistic infection (odds ratio = 1.67, 95% confidence interval: 1.1–2.5), absence of disclosure of status (odds ratio = 1.6, 95% confidence interval: 1.0–2.5), advanced World Health Organization stage (odds ratio = 4.2, 95% confidence interval: 1.6–10.5), and drug substitution (odds ratio = 2.0, 95% CI: 1.5–2.7) were significantly associated factors. Conclusion: The pooled prevalence of treatment failure among children living with HIV in Ethiopia was lower when compared to most African countries. Accordingly, either prevention or early treatment of opportunistic infection and advanced World Health Organization clinical stages, special care for children whose either parents are deceased, advocating disclosure of status, and avoiding drug substitution as much as possible were still needed to prevent treatment failure.

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Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis

et al. 2022

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Introduction Adolescents living with HIV are subject to multiple co‐morbidities, including growth retardation and immunodeficiency. We describe growth and CD4 evolution during adolescence using data from the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) global project. Methods Data were collected between 1994 and 2015 from 11 CIPHER networks worldwide. Adolescents with perinatally acquired HIV infection (APH) who initiated antiretroviral therapy (ART) before age 10 years, with at least one height or CD4 count measurement while aged 10–17 years, were included. Growth was measured using height‐for‐age Z‐scores (HAZ, stunting if <‐2 SD, WHO growth charts). Linear mixed‐effects models were used to study the evolution of each outcome between ages 10 and 17. For growth, sex‐specific models with fractional polynomials were used to model non‐linear relationships for age at ART initiation, HAZ at age 10 and time, defined as current age from 10 to 17 years of age. Results A total of 20,939 and 19,557 APH were included for the growth and CD4 analyses, respectively. Half were females, two‐thirds lived in East and Southern Africa, and median age at ART initiation ranged from <3 years in North America and Europe to >7 years in sub‐Saharan African regions. At age 10, stunting ranged from 6% in North America and Europe to 39% in the Asia‐Pacific; 19% overall had CD4 counts <500 cells/mm3. Across adolescence, higher HAZ was observed in females and among those in high‐income countries. APH with stunting at age 10 and those with late ART initiation (after age 5) had the largest HAZ gains during adolescence, but these gains were insufficient to catch‐up with non‐stunted, early ART‐treated adolescents. From age 10 to 16 years, mean CD4 counts declined from 768 to 607 cells/mm3. This decline was observed across all regions, in males and females. Conclusions Growth patterns during adolescence differed substantially by sex and region, while CD4 patterns were similar, with an observed CD4 decline that needs further investigation. Early diagnosis and timely initiation of treatment in early childhood to prevent growth retardation and immunodeficiency are critical to improving APH growth and CD4 outcomes by the time they reach adulthood.

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Prevalence and Factors Associated With Virological Treatment Failure Among Children and Adolescents on Antiretroviral Therapy Attending HIV/AIDS Care and Treatment Clinics in Dodoma Municipality, Central Tanzania

Cited by 29 publications

References 38 publications

Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

Determinants of Virological Failure Among HIV-Infected Children on First-Line Antiretroviral Therapy in West Gojjam Zone, Amhara Region, Ethiopia

Treatment failure and its associated factors among children receiving highly active antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

Growth and CD4 patterns of adolescents living with perinatally acquired HIV worldwide, a CIPHER cohort collaboration analysis

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